Disc prosthesis replacement and interbody fusion in the ..
Artificial Disc Replacement | Greg Malham
Artificial Disc Replacement (ADR) - USC Spine Center
Funding continues for lumbar artificial discs. Cervical and lumbar artificial discs are available for self funded patients or approved Workcover and Transport Accident Commission patients.A cervical artificial disc replacement can be used to treat pain arising from a damaged disc which is compressing the spinal cord or nerve roots which has not responded to non operative care such as medication, injections, rest and physiotherapy.A lumbar artificial disc replacement is used in symptomatic disc degeneration with discogenic pain without significant facet joint disease.Prior to the development of artificial discs, the only surgical option was fusion, where adjacent vertebral bodies were fused together, using interbody cages and bone after the damaged disc was removed.The goal of artificial disc replacement is to:Artificial disc replacement is usually performed in patients under 55 years of age.Certain conditions prevent a patient from receiving an artificial disc.
Malham.Single level cervical and lumbar disc injury – one level artificial disc replacement is appropriateSingle level cervical and lumbar adjacent segment disease above a previous fusion level – one level artificial disc replacement is appropriateTwo level cervical disc injuries – two level artificial disc replacement is appropriateTwo level lumbar disc injuries at L4/5 and L5/S1 – perform “Hybrid” surgery with L5/S1 anterior lumbar interbody fusion (to provide stable base) and then L4/5 artificial disc replacement (to maintain motion above and reduce risk of adjacent segment disease).Mr.
Dr McCombe is an orthopaedically trained spinal surgeon
Dr McCombe is an . He has a special interest in disc replacement surgery in the lumbar (low back) spine and cervical (neck) spine as well as in disorders of spinal posture (sagittal imbalance). He is also interested in cases of deformity causing nerve compression such as spondylolisthesis and degenerative adult scoliosis. He inserted the first cervical disc replacement in Australia in 2000. He has an interest in spinal implant design and, in conjunction with a neurosurgical colleague, has designed two implant systems used for posterior lumbar interbody fusion (R90 and Capstone Contol). He conducts clinical research into patient outcomes and theoretical mathematical analysis of spinal balance.
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