Artificial Disc Replacement 10 years After

In April 2000, Joe Kilraine suffered a fall that resulted in a broken knee and damage to his spinal column. His injuries progressed to degenerative disc disease (DDD), which left him in chronic pain and significantly disabled. For several years, Joe tried every conservative treatment he could find for his back pain, including narcotic pain relievers, on which he became dependent.

DDD is an inevitable aspect of aging; however, not all patients are in pain. As a result of his fall, Joe was in pain and needed surgery on his spine. DDD causes compression of the nerve roots, with pain often radiating down the legs or into the feet and it may also be associated with numbness and tingling.The most common surgical treatment for patients with DDD has historically been spinal fusion. In this procedure, spinal vertebrae are fused together to strengthen and stabilize the spine. The major disadvantage to this procedure is that most patients lose mobility and flexibility in the area of the spine where the fusion took place.

Joe felt strongly that this was not the surgical procedure for him. He began to look for an alternative, and discovered that a new technology in spinal surgery, artificial disc replacement, was on the horizon. Like hip and knee replacement surgery, artificial discs have the potential to return patients to a pain-free lifestyle with full function and mobility.

Joe soon discovered that the use of artificial discs was being studied in several clinical trials in the United States. It was Joe's good fortune to be referred to Dr James Yu at Yale New Haven Hospital who was working with and being mentored by Dr Rudolf Bertagnoli, in ADR procedures and prosthetics pioneered and perfected by Dr Bertagnoli.

Unfortunately Joe did not qualify for the US ADR studies because he had DDD at more than one or two levels of his spine. Dr Bertagnoli was accomplished in such surgery in Europe where he had been performing artificial disc replacement surgery for several years, and accepted into Dr Bertagnoli's care.

Joe traveled to Vienna, Austria where he underwent a surgical procedure in which three of the discs in his lumbar spine (L-2/L-5)were replaced with artificial discs. After four years of pain and disability and a total loss of his quality of life, Joe finally found relief. "I walked the day after my surgery which was on November 17th, 2003 and now ten years later, I am quite healthy and my back has not trouble me since. Having been an avid jogger and athlete, Joe actually resumed jogging 2 weeks following the surgery and was back to high mileage training, within a month never missing since then to date. In fact, I was able to regain marathon level stature within a few months following surgery after almost six years of imposed inactivity and continue to jog daily to the present. The results are miraculous."

The Food and Drug Administration subsequently approved the use of an artificial disc device for patients with DDD, but with limited restrictions, including involvement of more than one or two adjacent levels of the lumbar spine. While this has been a welcome step forward, additional research and acceptance is needed, especially for patients like Joe whose disease does not fall within the current limited criteria for eligibility. Continued funding for the development of surgical procedures and technologies that can change a person’s life by returning them to a pain-free and productive life is not only worthwhile, but also essential.

Joe is a chemical, as well as, polymer engineer, understands both the mechanical dynamics and materials of construction relationships associated with ADR and such knowledge has enabled his confidence in the sustained benefits and superior outcomes to be realized with ADR.

Dr. Bertagnoli's expertise and gift to me is also a true gift to science and mankind and his efforts with excellent surgeons have advanced and extended his influence to many other patience in need of such care. My wish is that it may continue and accelerate. Thank you Dr. Bertagnoli.

Joe Kilraine