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Disc helps conquer back pain

Dr. Jeffrey Larsen, left, and his patient, Wilma Turner, look at a model of a replacement spine disk at Kootenai Medical Center on Friday, a day after Turner became the first patient in the Northwest to receive the replacement disk in her back, put there by Larson, a spinal surgeon. (Jesse Tinsley / The Spokesman-Review)
By James Hagengruber
Dr. Jeffrey Larsen, left, and his patient, Wilma Turner, look at a model of a replacement spine disk at Kootenai Medical Center on Friday, a day after Turner became the first patient in the Northwest to receive the replacement disk in her back, put there by Larson, a spinal surgeon. (Jesse Tinsley / The Spokesman-Review)

The first artificial spinal disc in the Northwest was implanted Thursday at a Coeur d’Alene hospital in the lower back of Wilma Turner, a 55-year-old poodle breeder and horse rancher from Newman Lake, Wash.

Turner hurt her back four years ago in a car crash. She tried to conquer the resulting back pain with all manner of physical therapy and injections. But the pain slowly became crippling. Fusing the vertebrae together seemed to be her only option, she said.

At the end of October, however, the U.S. Food and Drug Administration approved the first-ever artificial spinal disc and the Kootenai Medical Center in Coeur d’Alene happened to have one of the nation’s few neurosurgeons trained to install the cobalt steel and high-density plastic device.

The procedure lasted about 90 minutes and Turner was up shuffling around Friday. She said she was looking forward to being able to ride her horses and motorcycles again. “I have been totally active for my whole life.”

The surgery was the first anywhere in the Northwest, said the surgeon, Dr. Jeff Larson. Another is already scheduled for Thursday in Coeur d’Alene. Larson said a colleague in Spokane, Dr. John Shuster, also has been trained in implanting the device.

Larson said he expects the artificial disc to someday be as common as artificial knees or hips. There’s nothing like the real thing, he said, but the artificial disc has considerable advantages over standard disc fusion surgery, which is successful at reducing pain, but at a cost of limiting movement and a lengthy recovery time.

“This is a tremendous advance,” Larson said. “It’s an exciting time for patients with back pain.”

The Charité Artificial Disc, manufactured by DuPuy Spine, is only suitable to replace the lowest two discs of the spine. About 200,000 Americans need lower lumbar fusion surgery each year, according to the American Association of Neurological Surgeons. The artificial device might work for 20 percent of these cases, Larson said. Ideal candidates are between 20 and 60 years old.

Cartilage discs between spinal vertebrae are often compared with a jelly doughnut – a tough, outer core and squishy center. The discs lose some of their cushioning ability over time, but traumatic injury or repeated strains speed up the process for millions of Americans, Larson said. Lower back pain is the leading reason for missing work and the second highest cause of emergency room visits.

If torn or damaged discs can’t heal on their own – healing takes a long time because little blood reaches the disc – surgery is often the last, best chance to fix the pain, Larson said. Fusing discs is still a good option, but recovery from the surgery can take between 6 months and a year. The procedure also limits motion and transfers additional stress onto neighboring discs.

A recent study comparing the results between fusion and the fake disc found no difference in safety of the procedure, Larson said. Both procedures were effective at cutting pain, but patients with the artificial disc typically recovered twice as fast and had a full range of back motion. It’s too early to tell if the artificial disc will prevent degeneration in neighboring discs, Larson said. The device has been engineered to last a lifetime of flexes and bends.

Cost is similar to standard disc fusion surgery, Larson said. Although the device is new, some insurance programs are already paying for it.

The artificial disc has been in use in Europe, where it was developed, for 17 years. Two other companies are currently testing artificial discs in the U.S., but have not yet received approval for widespread use from the federal government, Larson said.

Larson, a board-certified neurosurgeon, moved to Coeur d’Alene from Spokane just over a year ago to establish a spine center at Kootenai Medical Center. The non-profit hospital also launched a heart program last year as part of its strategy to offer more medical procedures to the fast-growing counties of North Idaho.