What is an artificial disc replacement?

An artificial disc is a device that is implanted into the spine to replace a degenerative disc, whose regular function is to carry weight and allow motion. A disc is the soft cushioning structure between the individual bones of the spine, (called vertebra). Artificial discs are usually made of metal and plastic-like (biopolymer) materials, or a combination of the two. These materials have been used in the body for many years.

Why would a doctor recommend an artificial disc replacement?

The reasons for choosing to replace a disc may vary for each condition. Generally, if the pain caused by the affected disc has not been reduced enough with non-surgical treatments, such as medication, injections, or physical therapy, a doctor may suggest disc replacement. Several conditions that may prevent you from receiving a disc replacement: spondylolisthesis (the slipping of one vertebral body across a lower one), osteoporosis, vertebral body fracture, allergy to the materials in the device, spinal tumor, spinal infection, morbid obesity, significant changes of the facet joints (joints in the back portion of the spine), pregnancy, chronic steroid use or autoimmune problems.

What does an artificial disc replacement involve?

Your spine surgeon will gather a variety of information before recommending disc replacement surgery. In addition to taking a history and doing a physical exam, your surgeon may order various diagnostic studies, such as X-rays, magnetic resonance imaging (MRI) scans, CT scans, or discograms (a special X-ray with dye that show more detail).

Pre-Surgery Preparations

Once you and your surgeon have agreed about the need for disc replacement surgery, some preparations are normally required:

• You should stop smoking as soon as possible before surgery, as it will increase your chances of a successful result




• Discussions with your family and other people who may be assisting you once you return from the hospital.




• You may need to visit your primary care physician or internal medicine specialist to obtain medical clearance for surgery.

Surgery

After the anesthesia has taken effect, the patient is laid on their back in order for the surgeon to get access to the spine through the front of the body-a pillow is normally placed under the low back. One surgeon is either a general or vascular surgeon while the other is a spine surgeon.
The surgeon makes a small incision near your belly button. Working through the abdomen, the organs are carefully moved to one side. This makes it easier to see the front of the spine. An X-ray is taken at this time to get a clearer picture of disc to be replaced. The disc is then removed, the area prepared, and the replacement inserted. A second X-ray may be taken to double check the location and fit of the new disc.

How long is the recovery after artificial disc replacement surgery?

Most people spend one or two nights in the hospital. You may require an extra day or two if for some reason you're having extra pain or unexpected difficulty. Patients generally recover quickly after an artificial disc replacement. You should be able to get out of bed and walk within a few days. Some people wear a corset or brace for support. As you recover in the hospital, a physical therapist may see you to start you on a few gentle exercises. You'll also start a walking program that you are encouraged to continue when you get back home. When you leave the hospital, you should be safe to sit, and walk. Your surgeon will see you within a month to do an X-ray to make sure the disc is in place and holding steady. However, you should avoid lifting things for at least four weeks. You can often return to work after your surgeon has evaluated you, as long as your job does not include heavy lifting. It should be noted that a successful result of the disc replacement means that back symptoms are better but not necessarily perfect. Most studies show that 60 to 70 percent of patients have significantly less back pain and greatly improved function with the operation.

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