For most patients, an artificial disc replacement will last an average of 70 years without the need for a revision artificial disc replacement. Simulated wear suggests artificial discs could last a minimum of 40 years and perhaps between 50 to 100 years1, though most people are unlikely to get a century out of these medical devices. As it turns out, the answer to the question, “How long does an artificial disc replacement last?” is in the details.
Most sources say that an artificial disc replacement lasts at least 10 years. This is almost certainly an overly conservative estimate. The reason most sources cite 10 years is because that is the length of time most clinical trials of artificial discs were followed. In clinical trials with 7 to 13 years of follow-up, more than 90% of people still have a working artificial disc.2-4 So can an artificial disc last even longer than 10 years? Absolutely, but we don’t have a lot of good clinical information to tell us exactly how long they will last beyond about 13 years.
While clinical trials are extremely expensive—especially those that last more than a decade—simulation studies are relatively inexpensive and can reveal important information about the structural integrity of artificial discs. Since it would be impractical to conduct a clinical trial lasting 100 years, researchers used a machine that re-creates the forces that an artificial disc would need to withstand inside the human spine. The scientists found that artificial discs could withstand approximately 10 million simulation cycles. This number of simulation cycles equates to between 50 and 100 years of wear.1 Of course, artificial discs that are actually inside the human body may not perform quite that well, but it does suggest that for artificial disc durability, 10 years is a big underestimate.
When considering the durability of artificial discs, one must also consider the main surgical alternative, namely spinal fusion. A primary question that individuals ask, is what’s better: artificial disc replacement or spinal fusion? In spinal fusion, two or more vertebral bones are fused together in an effort to stabilize the spine and treat chronic pain. Patients who opt for spinal fusion give up the increased flexibility and range of motion they would get with an artificial disc replacement, but the hope is that spinal fusion surgery is permanent. But is it really?
Researchers performed a comprehensive literature review comparing outcomes from hundreds of patients with ether artificial disc replacement or spinal fusion surgery. The results varied widely, but the authors reported that two years after surgery, the overall reoperation rate ranged from 3.7 to 11.4% in the artificial disc replacement group and ranged from 5.4 to 26.1% in the spinal fusion group.5 This means that people treated with spinal fusion surgery were about twice as likely to need a second operation to correct the first surgery than those treated with artificial disc replacement.5 It should also be noted that this study was published in 2010, and the quality and durability of artificial discs has almost certainly improved since that time.
There is no guarantee that an artificial disc replacement will last forever, and some patients will have to either have another artificial disc replacement surgery or move to spinal fusion. Nonetheless, people who are considering artificial disc replacement should seek out a qualified spine surgeon with ample experience in this procedure. Since spinal fusion surgery has been around longer and is a simpler procedure for surgeons to perform, some spine surgeons will recommend fusion even when artificial disc replacement is the better option for patients. Patients can protect their interests by choosing a spine surgeon who has performed many artificial disc replacements. That experienced professional can always perform a spinal fusion if that is the better choice for you.
The other major advantage of seeking out an experienced spine surgeon is that patients can learn about the different types of artificial discs or ask questions like “what is artificial disc replacement?” with an answer providing complete peace of mind.. Over time, surgeons have learned that some artificial discs perform better than others in certain situations. A knowledgeable provider can guide your selection. Perhaps most importantly, choosing the right spine surgeon and the right device for the right patient can reduce the risk of needing a revision artificial disc replacement.