When Should You Opt for a Lumbar Total Disc Replacement?

Many people across the globe suffer from spinal problems. As such, disc replacement surgery may be advised to treat chronic, acute lower back pain caused by progressive disc degeneration. Even so, lumbar total disc replacement is only recommended if nonsurgical treatments have failed for at least six months and the discomfort interferes with daily activities. And in this procedure, the uncomfortable spinal disc is replaced with a device that mimics the disc’s normal movement during surgery. As such, artificial disc replacement relieves pain by lessening aggravating micro-motion, stabilizing the spinal segment, and reducing inflammation.

Spinal Fusion and Artificial Disc Replacement

Lumbar total disc replacement and lumbar fusion are the two basic operations for treating painful and functionally debilitating lumbar disc degeneration.

• Spinal fusion: The standard operation for disc disease is spinal fusion. Here, the lumbar segment is immobilized, and a disc is extracted from the spine to allow the two neighboring vertebrae to merge using a structural and biologic implant such as rods, screws, or plates. Spinal fusion aims to eliminate unpleasant movement between two vertebrae, reducing lower back discomfort.
• Lumbar disc replacement: During this operation, the problematic lumbar disc is extracted and substituted with a synthetic disc that allows the spine to move freely. A lumbar total artificial disc replacement aims to reduce pain by minimizing the instability and muscular strain induced by painful micro-motions at the level of the deteriorated disc.

Who Is a Lumbar Disc Replacement Candidate?

Your surgeon may suggest a few tests to evaluate whether you’re a suitable candidate for disc replacement, including:

• Scans using MRI
• Discography
• CT scans
• X-rays

These procedures will also aid your surgeon in determining the cause of your back discomfort. Meanwhile, artificial disc replacement is not the best option for all people with low back discomfort. And the following features are common among good candidates for disc replacement:

• One or two troublesome intervertebral discs in the lumbar spine causing back pain.
• There is no evidence of substantial facet joint pathology or bone compression of the spinal nerves.
• Obesity
• There hasn’t been any substantial lumbar spine surgery in the past.
• There is no spinal deformity (scoliosis).
• There isn’t osteoporosis.

Recovery

After artificial disc replacement, you will most likely spend 1 to 3 days in the hospital. And the duration of your hospitalization will be determined by how well your pain is managed and how quickly you regain function. Patients are usually advised to stand up and walk on the first day following surgery. Meanwhile, because bone fusion isn’t necessary after artificial disc replacement, patients are urged to maneuver through the midsection. As such, early trunk mobility may result in faster rehabilitation and recovery. However, since your bone must repair the prosthetic disc, prolonged motions should be avoided, while limitations will be discussed with you by your doctor. And during the first few weeks after surgery, you will undertake simple exercises such as walking and stretching. It’s also crucial to avoid any activity that causes your back to hyperextend during this time.

Developments in the form of implants and techniques for detecting the source of discomfort and developing strategies to return the disc to healthy functioning without installing a biomechanical device are anticipated to be part of the future of synthetic disc replacement technology. In the meantime, artificial disc replacement is a more recent development than lumbar fusion, despite no longer being considered new technology. And in a carefully selected patient population, follow-up studies up to ten years have demonstrated good results.