Total Disc Replacement

Artificial disc replacement is an excellent alternative to spinal fusion for the appropriate candidate for surgical treatment of severe disc problems. The surgery is indicated for patients with severe degenerative disc disease. As spinal structures degenerate, they may cause pain, limiting function and decreasing quality of life. Total disc replacement (TDR, also called artificial disc) surgery is a recent advancement in spine surgery.

GOAL:

To provide an improved successful alternative procedure than a fusion to a spinal joint.

The goal is to maintain the intervertebral disc height while maintaining normal joint motion similar to a healthy disc

BENEFITS:

The benefits of disc replacement are to preserve motion and reduce abnormal stresses at the disc above and below the surgery.

  • Patients who receive an artificial disc often have a speedier recovery than those who underwent a spinal fusion.
  • Artificial disc replacement eliminates the need for bone grafting
  • It can be done using minimally invasive techniques in an outpatient setting, depending on the health of the patient and the complexity of procedure required
  • It results in maintaining good range of motion at that level.
  • There is no likelihood of pseudarthosis
  • Limited bleeding
  • Immobilization is typically less than a week

ANATOMY:

The intervertebral discs attach to adjacent vertebrae as well as absorbing the wear and tear of the body’s movements.

When the discs shrink, the spinal nerves can become compressed and cause significant pain.

CONDITIONS TREATED:

If you are one of the many people who deal with conditions such as herniated discs, bulging discs or spinal stenosis, then disc replacement surgery is a consideration for you.

PROCEDURE

A cervical total disc replacement, requires the surgeon to make an incision in the front of the neck and move the contents of the neck to the side, enabling the front of the spine to be seen.

For a lumbar total disc replacement, an incision is made in the abdomen to expose the front part of the spine; the surgery proceeds after carefully moving the abdominal contents and blood vessels to the side.

Fluoroscopy is used to identify the correct level(s) before the disc material is removed and the artificial disc is inserted.

A cervical total disc replacement surgery takes approximately 1-2 hours; a lumbar total disc replacement surgery takes about 1-3 hours.

RISKS:

Disc replacement surgery is generally safe, but it does have a few risks including:

  • Infection
  • Excessive bleeding
  • Reaction to anesthesia
  • Chronic unresolved spine pain
  • Damage to the nerves, spinal cord, esophagus, or vocal cords-if the replacement is in the cervical area
  • Failure to heal

Recovery can be faster than for traditional fusion surgery with less less pain from the procedure and fewer complications in general.

The hospital stay is usually 1-2 days but if the procedure is done in an ASC (Ambulatory Surgery Center), you may leave the same day.

A cervical collar or lumbar corset may be prescribed for several weeks to allow for adequate healing.

Discharge instructions and an exercise protocol will be given for home management.

You will be able to ride in a car or plane upon leaving the hospital.

Physical therapy may be initiated by your doctor.

Recovery will vary among patients depending on the extent of the surgery as well as the age and health of the individual.

Return to work also varies greatly among patients and is related to the patient’s general health and their work environment.