Replacing a Damaged or Diseased Disc in Your Back

Alleviating Back Pain with Total-Disc-Replacement Surgery

Back pain is among the most common and excruciating conditions suffered by Americans. Ideally, you want to relieve your discomfort with non-invasive or minimally-invasive procedures. When those efforts are ineffective, though, you may need back surgery. One option proven to be highly effective is the total replacement of a damaged or herniated disc.

Total disc replacement is a surgical procedure in which diseased or damaged discs of your spinal column are replaced with artificial discs, restoring the normal function and movement of the spine. Total disc replacement is a relatively new procedure, developed as an alternative to spinal fusion for the treatment of diseased or damaged discs.

When Total Disc Replacement Is Appropriate

Total-disc-replacement surgery may be recommended for patients with back pain from degenerative disc disease, a condition of gradual degeneration of discs caused by the natural aging process. The procedure is customarily prescribed for patients whose disc problems have not responded to non-surgical treatment options.

Total-disc-replacement surgery is generally not advised for patients with spinal infection, osteoporosis, allergy or sensitivity to implant materials, spondylolisthesis, or spinal tumors. The surgery also is not recommended for anyone who is pregnant or morbidly obese or who has used steroids for a lengthy period of time or had prior spinal surgery.

The Total-Disc-Replacement Procedure

Total-disc-replacement surgery is performed under general anesthesia. During the surgery, the patient is positioned on their back on an operating table. The surgeon makes an incision near the belly button. The internal organs and the blood vessels are carefully moved aside to gain access to the spine. An X-ray is then taken to see a well-defined image of the disc to be replaced.

The surgeon then removes the diseased disc and prepares the disc space to receive the new artificial disc. The metal endplates of the implant are inserted and tapped into the correct position. Finally, the sliding polyethylene core is placed between the endplates. As the vertebrae are returned to normal posture, the pressure of the spinal column places the endplates into the vertebral bones and secures the sliding core in position. After the procedure, another X-ray is taken to verify the position and fit of the new disc.

Post-Operative Care

Disc-replacement surgery typically requires a hospital stay of 2 to 4 days, depending on your progress. You should be able to walk and stand by the first day after surgery. A brace or corset may be prescribed for support, and basic exercises, such as walking and stretching, are usually part of the rehab during the first weeks after surgery.

Risks and Complications

Total disc replacement surgery does carry certain risks, including:

  • Infection
  • Blood vessel injury
  • Wear and tear of device materials
  • Dislocation of the disc
  • Nerve damage
  • Damage to adjacent structures