Artificial disc replacement, often called total disc replacement, is a surgical procedure Beaumont spine surgeons perform to help with degenerative disc disease in the spinal column. Herniated or damaged discs are replaced with artificial disc devices in either the cervical or lumbar spine. Artificial disc replacement was developed as an alternative to spinal fusion surgery and is designed to reduce or eliminate a patient's pain level while still maintaining motion throughout the spine. In addition, it helps to relieve future stress placed on the vertebral discs above and below the surgical site.
Indications for this procedure can be very specific so make sure you discuss this treatment option with your doctor before deciding on a treatment plan.
The two primary types of artificial disc surgeries are cervical disc replacement and lumbar disc replacement.
Disc replacement surgery overview
Disc replacement surgery involves removing a diseased disc and replacing it with an artificial disc made of medical-grade metal or a combination of medical-grade metal and plastic. It is done when the space between the vertebrae has become too narrow and part of the vertebrae or disc is pressing on the spinal cord or spinal nerves, causing pain, numbness or weakness. When these symptoms do not respond to nonsurgical types of treatment, disc replacement surgery may be recommended.
Using an artificial disc to replace your natural disc is a new type of treatment that has recently been approved by the FDA. In traditional disc replacement surgery, the diseased disc is removed and the vertebrae above and below the disc may be fused together. Disc replacement surgery may have the advantage of allowing more movement and creating less stress on the remaining vertebrae than traditional spinal fusion surgery on the neck or back.
Reasons for the procedure
The reasons for artificial disc replacement surgery depend on the area of the spine in which the diseased disc is located, cervical or lumbar.
In the neck, loss of space between the cervical vertebrae from cervical disc degeneration, or wear and tear, is common. Cervical discs begin to collapse and bulge with age; this happens to most people by age 60. Doctors don't know why some people have more symptoms from cervical disc degeneration than others.
Symptoms may include:
- neck pain
- neck stiffness
- pain that travels down into the shoulders or arms
- weakness in the shoulders, arms, hands or legs
- "pins and needles" or numbness in the arms
Not everyone with back pain is a good candidate for a lumbar disc replacement surgery. A doctor will perform a number of tests to determine if it's the right procedure for each patient.
Lumbar disc replacement surgery might be recommended if:
- The source of back pain mostly comes from only one or two discs in the spine.
- There is no significant joint disease or compression on the nerves.
- The patient is not excessively overweight.
- The patient has not previously had spinal surgery.
- The patient does not have scoliosis or another spinal deformity.
Other factors also will be considered in the doctor's determination of whether a lumbar disc replacement surgery, a lumbar fusion surgery or another course of action is best.
Risks of artificial disc replacement
Disc replacement is a fairly new type of surgical spine surgery with little information on possible long-term risks, however they may be greater than traditional spine surgery as greater access to the surgical area is required than a standard minimally invasive procedure. Patients should discuss the risks and benefits of disc replacement surgery compared with more traditional types of spine surgery with the surgeon.
Some potential risks of spine surgery include:
- reactions to the anesthesia
- nerve injury
- spinal fluid leak
- voice change
- difficulty breathing
- difficulty swallowing
- failure to relieve symptoms
- broken or loosened artificial disc
- need for further surgery
There may be other risks, depending on the specific medical condition. Be sure to discuss any concerns with the surgeon before the procedure.