Nearly all of us know someone who had surgery to replace their bum hip or knee with an artificial joint. But artificial discs? Fewer have heard of this increasingly prevalent orthopedic surgery, according to Praveen Kadimcherla, MD, of Atlantic Spine Center.
Approved by the U.S. Food and Drug Administration in 2004, artificial disc replacement implants a synthetic disc into the spine to replace a worn or damaged disc. The procedure’s goal, Dr. Kadimcherla says, is to relieve chronic back pain while enabling more normal range of motion that might be possible with other back procedures, such as spinal fusion.
While an estimated 8 in 10 American adults will experience back pain at some point, according to the National Institutes of Health, surgery is rarely necessary and only used when pain doesn’t improve with conservative treatments such as exercise, physical therapy or pain relievers. When spinal fusion surgery is performed to fuse painful vertebrae into a solid bone, fusion can prevent normal spine motion.
“But artificial disc replacement doesn’t stop patients from bending or flexing normally, making it an increasingly popular option for chronic back or neck pain,” Dr. Kadimcherla explains.
Best questions to ask in advance:
Just because an innovative surgical option for back pain has emerged doesn’t make it right for everyone with back or neck pain, Dr. Kadimcherla notes. He suggests being ready to talk with your doctor about the possibility of artificial disc replacement with these 5 questions:
1. Am I a good candidate for artificial disc replacement?
Disc replacement is a better option for certain patients, including those whose back pain originates in only 1 or 2 discs in the spine. People with slipped or herniated discs may be good candidates for the procedure, but not those who suffer from degenerative disc disease, which can affect the entire spinal column. It’s also important not to have significant joint disease or spinal nerve compression, Dr. Kadimcherla says. “Good candidates for this surgery aren’t excessively overweight and they haven’t undergone spinal surgery before,” he adds. “They also can’t have scoliosis or another deformity of the spine.”
2. What happens during artificial disc replacement surgery?
In a 2- to 3-hour procedure, you’ll receive general anesthesia while lying on your back. While you’re asleep, surgeons will make an incision in your abdomen (if your disc replacement is occurring in the back), moving aside organs and blood vessels to allow access to your spine. If a disc is being replaced in your neck, the incision is made at the front of the neck. Your damaged spinal disc(s) will be removed and artificial disc(s) will be inserted in their place. After your incision is closed, you’ll go to a recovery room.
3. Are there any risks to artificial disc replacement surgery?
Like any surgical procedure, artificial disc replacement poses certain risks, however minor. The operation requires greater access to the spine than other spinal surgeries, Dr. Kadimcherla notes. Potential surgical risks include infection; dislocation of the new disc; implant failure or breakage; implant loosening or wear; stiffness of the spine; narrowing the spine due to a breakdown in spinal bones; and blood clots in the legs.
4. How can I prepare for artificial disc replacement?
Your doctor will take a detailed medical history and perform a thorough physical exam. You may also need imaging tests such as X-rays or an MRI or CT scan before surgery, along with blood tests. “Make sure to inform your doctor of all prescription and over-the-counter drugs you take as well as vitamins, herbs or other supplements, since medications and supplements can affect blood clotting and other aspects of healing,” Dr. Kadimcherla says. Just before surgery, you may be told not to eat or drink anything for several hours.
5. What is recovery like from artificial disc replacement?
The days just after surgery should allow rest and healing, Dr. Kadimcherla says. You may stay in the hospital for a few days, and you won’t be allowed to drive right away when you get home. You may also need help at home with activities such as dressing, cleaning and shopping. Pain will be controlled with appropriate medications and you’ll be encouraged to walk about within the first day, he says. “While you’ll need to avoid any jarring movements for a while, recovery should proceed steadily,” Dr. Kadimcherla explains. “Walking, stretching, and doing gentle exercises will all promote your return to normal life.”