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64 °F Forecast | Road Cams Tuesday, March 8, 2005 Today's News | Classifieds | Autos | Homes | Jobs | Tempo | Health | Community | Home Delivery SECTIONS Home Page Local News Sports Business Obituaries Life Opinion Tempo AP News Weather Classified Archives Site Map SPECIAL SECTIONS Since We Asked Outdoor Journal Menu Guide How To Guide Health Readers' Choice Real Estate Showcase Real Estate Guide Joy Magazine Homelife Magazine Wedding Guide Passport to the Rogue Valley SHOP OUR VALLEY AutoFinder HomeFinder JobFinder Classified Place an ad TOP JOBS EXTRA NIE Personals Movie Times TV Times E The People Volunteer Moving here? eSouthernOregon CUSTOMER SERVICE FAQ's Advertise with us Home Delivery Employment Contact Us Media Kit Oregon Road Conditions & Cams Email Story to a Friend January 24, 2005 Dr. Paul Amstutz of Ashland holds a display model of the newly approved Charit� artificial spinal disc installed between two artificial plastic vertebrae. The Food and Drug Administration recently approved the disc for use in the United States. Mail Tribune / Jim Craven Disc implant may relieve some back pain By BILL KETTLER Mail Tribune Low-back pain may cause less misery in Southern Oregon now that federal regulators have approved an artificial spinal disc for use in the United States. Several Rogue Valley physicians have already made plans to offer their patients the Charit� artificial disc (named for the hospital in Germany where it was invented). The federal Food and Drug Administration certified the disc late in 2004. "This is the new frontier for spinal surgery," said Dr. Paul Amstutz, an Ashland neurosurgeon. Amstutz said patients have been asking him and other physicians about the artificial disc since they learned about it while researching their medical problems on the Internet. "All of us have been asked, ‘Can I have an artificial disc?’ " he said. Advertisement The answer depends on the individual’s spinal condition and general health. Amstutz noted that the artificial disc has been approved only for the joint between the fourth and fifth vertebrae (known as L4 and L5) of the lumbar spine and for the joint between the fifth lumbar vertebra and the sacroiliac (S1). He cautioned that lower back pain comes from many different sources, and disc replacement is not appropriate for treating many of them. Other medical conditions such as osteoporosis could also disqualify patients from a disc replacement. "Once you’ve gone through diagnosis and evaluation there’s a relatively small number of people for whom it’s appropriate," Amstutz said. He said the artificial disc would be most appropriate for people under age 60 who suffer back pain from a single injury. Chronic back pain is a problem for millions of people, but it comes from many sources, including ruptured discs and pinched nerves. One common cause is degenerative disc disease, which occurs when spinal discs deteriorate. The discs lose moisture, shrink, and become less pliant as a result of natural aging. The deterioration causes vertebrae to rub against each other, which can cause pain or numbness. Medical researchers have struggled for years to find a material that could replace natural disc material. Rubber discs disintegrated rapidly under the pressures the spine produces. Industrial ball bearings were tried, too, but the sometimes popped out of the space between the vertebrae, Amstutz said. Physicians formerly had few options for treating a failed joint other than fusing the vertebra, but that only put more stress on adjacent joints in the spine. "If you lose one joint you just have to spread the motion (in the spine) to the other joints," Amstutz said. The extra pressure often caused more pain in adjacent discs over time. The goal in replacing a disc is "to try to stabilize and preserve the other discs," Amstutz said. The artificial disc includes two metal alloy endplates and a hard plastic core that allows the spine to flex and extend just as it would with a natural disc. Small metal tabs in the endplates are inserted into the vertebra above and below the damaged disc to seat the device firmly in the spinal column. The Charit� disc was developed by physicians in what was formerly East Germany during the 1980s, and has since been used widely in Europe, Asia and Latin America. A two-year clinical study of 375 patients in the United States showed that those implanted with the Charit� disc improved or maintained their range of motion and experienced less pain compared with spinal fusion patients, according to a Web site maintained by the department of neurological surgery at the University of Pittsburgh. Physicians will be trained in using the new disc before they perform surgery to implant it. Dr. Glen O’Sullivan of Ashland has already attended a training session, and Amstutz is waiting to be trained in placing the artificial disc. Amstutz said back pain will continue to attract researchers’ attention because it afflicts so many people and comes from so many sources. The artificial disc is "a wonderful advance," Amstutz said, "but it won’t be the end of the controversy over back pain." To learn more about the disc, type "Charite artificial spinal disc" into any Internet search engine. Reach reporter Bill Kettler at 776-4492, or e-mail [email protected] Mail Tribune Home | Local News | Sports | Business | Obituaries | Life | Opinion AP News | Archives | Site Map | Community | Classified Copyright © 1997-2005 Mail Tribune, Inc. All rights reserved. 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