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PITTSBURGH (KDKA) — The joints in Nate Snyder’s backbones had worn out.
“I couldn’t really stand up straight. I had a constant hunch,” he said.
He had pain from his low back to the tips of his toes.
“At first, I was in denial about it, and I thought, if I keep going maybe this will go away,” he said.
The breaking point was when his 16-year-old daughter asked him to go for a jog, and he couldn’t.
“I just can’t take the pain anymore. I need to do something,” Snyder said.
He had a narrowing of the spinal canal, which pressed on the nerves.
He saw neurosurgeon after neurosurgeon who offered to do a spinal fusion.
In this operation, the surgeon removes the back portion the spine, and fixes the backbones together with bolts and screws. But this can increase the stress above and below the fusion, leading to more surgery down the line.
“I’m 44-years-old, I’m not an old guy. I have an 8-year-old son. I want to still be active. I didn’t want to lose that range of motion,” he said.
“Ideally, what we would like to do in the spine is similar to what has been done in the other joints, the knees, and the hips, where you actually put motion segments back in place,” Allegheny Health Network neurosurgeon Dr. Donald Whiting said.
What doctors have come up with is a joint replacement for a spine, a challenge with its comparatively small size.
“And you can see it has a little shock absorber in it, and that lets you have motion in there, so that you can bend forward and backward,” Dr. Whiting said. “So it’s really good for people who are young and active, who would normally need a fusion, but this is a good way to maintain motion.”
But it’s not FDA approved yet. It is in study for people with spinal canal narrowing with back pain and leg symptoms, problems at only one level, and a relatively healthy disc in between the back bones.
Participants are randomly assigned to get a fusion or the new artificial joint.
As for the people who don’t get the investigational joint replacement…
“They are disappointed if they don’t get the facet joint, because they’re usually pretty excited about the idea, but in the end, they get the surgery they would have had anyway if they don’t get the facet joint,” Dr. Whiting said.
If the study shows people do no worse with the implant than with a fusion, it will go before the FDA. Even if it gets approved, it could be a while before it becomes widely available.
“Then it has to go through the federal government, to get it paid for, and then the insurance companies to get it paid for,” Dr. Whiting said.
Snyder is glad he was assigned to get the artificial joint. He’s able to run, golf, and keep up with his kids.
“The pain was gone. I could tell immediately as I woke up,” he said. “It was kind of miraculous. I haven’t felt like that in 15 years.”