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Like so many people with lower-back pain, Danno Williams made adjustments. He rolled out of bed instead of just sitting up. He draped his arms on the steering wheel of his truck to drive without putting pressure on his spine.

He walked with his wife on his left side so if his left leg went numb, as it was prone to do, she could grab him before he fell over.

The 28-year-old Fromberg man's back was so out of whack that he could feel a 3/4-inch knob poking out from beneath his skin.

"You could reach out and run your finger down (my spine), and it would just stop," Williams said.

The bump was a misaligned vertebra. The disc separating that vertebra from the next one had been destroyed in a fall, leaving the first vertebra cockeyed.

Williams, an electrician, was installing a satellite dish from the top of a 20-foot extension ladder when the ladder collapsed.

"It pinched my feet in there, and I couldn't get out," he said.

He landed on his lower back on a four-by-four post. He could barely walk after the fall, but an emergency room doctor told him to go back to work.

Four months later, in February, he woke up one morning and couldn't walk at all.

He ended up in the office of Dr. Michael Copeland, a neurosurgeon with Northern Rockies Neurosurgeons in Billings.

If he had turned up in Copeland's office a year earlier, the doctor would have recommended removing the damaged disc and fusing together the vertebrae on either side of it.

But Williams had the good fortune to injure his back several months after Copeland began surgically implanting artificial discs into patients' spines.

The artificial disc, marketed under the brand name Charité, was approved by the Food and Drug Administration in October 2004, and Copeland put one into a patient for the first time in March 2005.

"We have a lot of luck with these," Copeland said. "The folks who do well do extremely well."

A disc is a like a pillow made of cartilage and soft tissue that separates and cushions the vertebrae.

If one slips or collapses, the vertebrae on either side of it can move out of alignment. If the bones shift a certain way, they can pinch the nerves that run down the spinal column. They can also rub on one another.

"When the padding wears out, you get more bone on bone friction, and it starts to hurt," Copeland said.

The Food and Drug Administration approved the metal-and-plastic artificial disc to replace the two lowest discs in the back. They are the ones that wear out most often because they bear the most weight and are in motion most often, Copeland said.

For younger patients, artificial discs work better than fusion, he said. Fusion eliminates pain, but it also forces the discs on either side of the fused vertebrae to work harder.

A person who is careful can function well with a fusion for about 20 years. After that, the next disc in line often needs attention.

"In a young person, you guarantee them another operation or two (with fusion)," Copeland said.

The artificial disc is thought to last for the rest of a person's life. Laboratory tests that simulated the way a spine works under pressure indicated the artificial disc would suffer little wear and tear after 80 years of use, Copeland said.

The disc is implanted during a three-hour operation. Patients typically spend three days in the hospital after the surgery and attend physical therapy for about six weeks.

"In six weeks, they can do whatever they want except for swinging sports," Copeland said. "I make them wait three months for that."

Steve Baldwin, a 47-year-old mechanic from Baker, was back at work and operating at full-bore six weeks after Copeland installed an artificial disc in his back.

"It was the best medical decision I've ever made," Baldwin said. "It's a good fix, and I do know a little bit about fixing stuff."

Baldwin doesn't know how he hurt his back — maybe playing football — but, by last fall, the pain grew serious enough that it kept him from working. If he managed to arrange himself on a mechanic's creeper to roll beneath a vehicle, he needed help to get back up.

Sitting for long periods, such as for the drive from Baker to Billings, was excruciating.

"There was no comfortable place," Baldwin said. "You had to keep changing positions."

Both Baldwin and Williams said their back pain vanished immediately after surgery. All that kept them from getting up and dancing jigs in the recovery room were the incisions on their bellies.

Williams expects to attend another month of physical therapy and head back to work about a month after that.

Contact Diane Cochran at dcochran@billingsgazette.com or 657-1287.

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