Lumbar Disc Arthroplasty
Lumbar Artificial Disc Replacements
Lumbar artificial disc replacement is a surgical method of replacing the diseased or damaged intervertebral discs of the spinal column with an artificial disc to restore motion to the spine. It can be considered as an alternative to spinal fusion for patients with low back pain.
Artificial disc replacement is indicated in patients with degenerative disc disease, a condition referred to as a gradual degeneration of the disc between the vertebrae caused by a natural process of ageing.
Your doctor may recommend certain tests such as, magnetic resonance imaging (MRI), discography, computed tomography (CT or CAT scan), and X-rays to identify the cause of pain. Patients with back pain caused from bulged or worn out intervertebral discs and patients with no significant facet joint disease are recommended for artificial disc replacement. The surgery is not recommended in patients with scoliosis, previous spinal surgery and morbidly obese.
During the surgery, an incision is made in the abdomen, and the muscles and the blood vessels are gently moved apart for better view and room for surgery. The disc space is opened and the damaged disc is removed and replaced with the artificial disc.
Artificial disc designs are of two types, disc nucleus replacement and total disc replacement.
With the disc nucleus replacement, only the central portion of the disc (nucleus) is removed and replaced with mechanical device, while the outer ring of the disc (annulus) is not removed. However, disc nucleus replacement procedure is not commonly practiced and is in investigative stage. In total artificial disc replacement, the annulus and nucleus are replaced with the mechanical device to restore normal spinal function. Artificial discs are usually made up of metal, plastic or a combination of metal and plastic. Medical grade plastic (polyethylene) and medical grade cobalt chromium or titanium alloy are used for disc design.
An artificial disc implantation does not require healing and therefore rehabilitation can be started soon after the surgery. Hospital stay of about 2 to 4 days may be required. Basic exercises including regular walking and stretching may be performed during the first few weeks after surgery.
Risks and Complications
Artificial disc replacement surgery may cause certain complications and they include:
- Injury to blood vessels
- Dislodgement or breakage of the device
- Wear of the device materials
- Continued or increasing pain
- Bladder problems