Artificial disc replacement is a surgical procedure to remove the diseased or damaged intervertebral disc and replace it with an artificial joint. In most cases, artificial disc replacement reduces or eliminates pain, restores spinal movement, and improves quality of life.
Artificial disc replacement has emerged as one of the leading surgical procedures to treat chronic neck or back pain. It is also the next logical step in the evolution of neurosurgery. Just as hips and knees are now replaced instead of fused together, so too are the discs of the spine replaced instead of fused.
The spine in the neck and back is a collection of bones, one on top of the next. This configuration gives the spine both its strength and its flexibility. The stack of spinal bones (i.e. vertebra) holds the weight of the head, arms, and chest. At the same time, the bones can move relative to one another, allowing us to bend and twist. When the spine is healthy, it is a marvelous thing.
In between most pairs of vertebral bones is a vertebral disc. Vertebral discs are both sturdy and pliable. They act as shock absorbers and cushions for the bones of the spine. Again, when vertebral discs are healthy, they are marvelous things.
Unfortunately, almost everyone older than 40 eventually develops some degree of degenerative disc disease. Degenerative disc disease is a condition where the intervertebral discs break down. In some, degenerative disc disease causes debilitating pain, decreased range of motion, and diminished quality of life.
Unlike spinal fusion surgery—the other surgical approach to treating chronic neck or back pain—artificial disc replacement allows the vertebral bones to move, to twist, and to bend. Thus, artificial disc replacement preserves range of motion in the spine.
Many—but not all—people are candidates for artificial disc replacement surgery. The main indication for artificial disc replacement is degenerative disc disease that may or may not be accompanied by radicular pain. Radicular pain is caused by compression or inflammation of nerves in the spine. To be a candidate for artificial disc replacement, a person’s neck or back pain is usually severe enough to significantly interfere with their ability to work or pursue active hobbies or sports.
In general, most people must have experienced at least 6 months of chronic neck or back pain not relieved by nonsurgical interventions. In other words, a person must have neck or back pain that persists after treatment with heat, maximal tolerated activity, physical therapy, oral analgesics, and/or corticosteroids before being considered a candidate for artificial disc replacement.
While the procedure can be performed on patients of almost any age, younger people, i.e., age 18 to 60, have the best outcomes and derive the most benefit from artificial disc replacement. The surrounding vertebral bones must be healthy enough to support the artificial disc. Thus, people who have had failed spinal surgery, osteoporosis of the spine, (retro)vertebral compression, or ankylosing spondylitis are not candidates for artificial disc replacement.
Dr. Lanman is a certified spine surgeon that offers Los Angeles artificial disc replacement and can answer all of your questions related to ADR. Only a qualified spine surgeon can help you decide if artificial disc replacement is right for you; however, you can review the pros and cons of the procedure.
The short-terms risk profile of artificial disc replacement is similar to spinal fusion surgery. However, the rate of complications is relatively low. The risk of complications can be further reduced by choosing a surgeon with the skill and experience to successfully perform artificial disc replacement surgery.
Spine.MD has compiled everything you need to know about artificial disc replacement. Whether you need to know more about what it is, the procedure, or if artificial disc replacement is right for you, our ADR resources can help you make the right decision. Learn directly from a real spine surgeon, Dr. Lanman, that performs artificial disc replacement and is an ADR Lead Investigator regularly comparing artificial disc replacement surgery vs. fusion: