Disc replacement is the surgical procedure in which a worn or damaged intervertebral disc is replaced by an artificial disc designed to allow continued motion of that part of the spine. The artificial disc is made of two metal components, with or without a plastic spacer in between. The metal plates are attached to the vertebrae that sit above and below the damaged disc. Your spine surgeon, often in conjunction with a vascular surgeon, performs the surgery through an incision made into your abdomen. Lumbar disc replacement is an operation which may be effective in relieving lower back pain due to a worn or damaged intervertebral disc.
Who is a Candidate for Disc Replacement?
You may be a candidate for disc replacement if your discomfort is primarily due to back pain which has not been alleviated by more conservative treatment measures, and if you do not have spinal instability or nerve compression. If there is evidence of nerve compression, disc replacement surgery alone may not be an effective surgical procedure for you. Disc replacement surgery is designed to replace the damaged disc while preserving the natural movement of the spine (unlike lumbar fusion in which the natural movement of the vertebrae is eliminated). The bone quality must be good with minimal effects of osteoporosis; therefore candidates for disc replacement are generally younger than 65 years old. Not every condition involving painful damaged discs can be treated with disc replacement. Your spine surgeon will carefully evaluate your condition and discuss any options with you.
How Long is the Recovery Period?
Recovery time varies from person to person. You may begin walking right after surgery and gradually resume other activities as you feel comfortable. Begin by walking around your house and progress to outside and longer distances. You can typically begin activities such as using a treadmill or swimming at three weeks, and return to your normal activities by four to six weeks. An active lifestyle will help to keep your bones and muscles strong, which will help prevent future injury. You should discuss specifics with your surgeon.
What are the Possible Complications or Risks of Disc Replacement?
While uncommon, complications can occur during and after surgery. During surgery, the nerves and spinal cord are exposed making the risk of nerve injury possible. The likelihood of this kind of injury seems to be related to whether there was damage to the nerve prior to surgery. Other complications that may occur with any surgery include wound infection, blood loss requiring transfusions or even causing death, and blood clots. General medical issues such as pneumonia or heart issues can be precipitated by surgery especially if you have prior problems. Your surgeon and health care team will be taking great care to help prevent these and other complications.
Will I Need a Blood Transfusion?
Not usually. Blood transfusions are rarely necessary for disc replacement. However, the approach for disc replacement surgery requires mobilization of some of the largest blood vessels of the body and therefore the risk for severe bleeding is present. For this reason, a vascular surgeon may participate in the surgery.
Will I Need Physical Therapy After Disc Replacement?
If you were able to function independently before surgery, it is unlikely that you will need physical therapy after you leave the hospital. However, if you had gait problems and long-term nerve compression, you may need physical therapy for gait training and strengthening. Physical therapy is often recommended for anyone who has significant difficulty with pain or mobility. Most likely you will be seen by a physical therapist before discharge from the hospital and if necessary, home health or outpatient physical therapy arrangements will be made for you.
Are There Other Factors That I Should Consider Before Undergoing Disc Replacement Surgery?
Disc replacement surgery is a relatively new procedure, and the long-term results are still unclear. In particular, it is not known how long the artificial discs will function in the body, the consequences of inevitable wear and tear, or if preserving motion, as opposed to performing a fusion, will accomplish the results that surgeons desire. There is no guarantee that disc replacement will permanently relieve back pain or that adjacent discs may not develop abnormalities causing pain and requiring further surgery.
What if I Have Other Questions?
Just give us a call at (941) 637-2499. We’ll be happy to answer any questions you may have. And be sure to ask us about our upcoming seminars on back and neck pain – we’d love to see you!