Artificial Disc Replacement

As little as one decade ago, Americans suffering from chronic, disabling pain caused by degenerated discs had only one surgical option, spinal fusion, if non-surgical treatment options didn’t work. Artificial disc replacement research, which occurred over four decades and continues today, was driven by the potential to overcome drawbacks to spinal fusion that include loss of motion and flexibility; permanently altered motion characteristics and biomechanics; and potential for accelerated degeneration of the discs above and below the fused level that can lead to more pain and the need for more back surgery.

Texas Back Institute was the first spine center in the U.S. to perform artificial disc replacement (ADR) in 2000. Today ADR is a common medical procedure, and demand for the procedure continues to grow.

Description


As spinal structures degenerate, they may begin to cause pain, limit function, and decrease quality of life. Artificial disc replacement (ADR, also called total disc) surgery is one of the latest advancements in spine surgery. During artificial disc replacement surgery, the damaged disc is removed and replaced with an artificial disc designed to allow for replication of normal motion. The hospital stay for this procedure is approximately one to two days.

Conditions Treated


Artificial disc replacement can be used to treat painful disc degeneration or disruption in the lumbar spine and the treatment of herniated disc, painful disc degeneration and radicular syndrome in the cervical spine.

Before the Procedure


Once you have decided to have surgery, the following events take place:
  • A medical examination.
  • Chest x-ray, EKG and blood work.
  • You may be asked to have a neurological or psychological examination.
  • If taking aspirin or anti-inflammatory medications daily, stop these medications at least one week before surgery.
  • If you take prescription medications or other drugs, including herbals, ask your doctor how soon before surgery you should stop taking these.
  • Do not have anything to eat or drink for 6 to 8 hours before surgery.
  • You will check into the hospital the morning of surgery.
  • Prior to surgery, you will be asked to sign permits for surgery, anesthesia, blood and blood products.

During the Procedure


  • An incision is made by a general surgeon in the abdomen to expose the front part of the spine.
  • Fluoroscopy (live x-ray) is used to determine the correct level(s) to be operated.
  • The disc is approached after carefully separating away the abdominal contents and major blood vessels are moved off to the side.
  • The disc is removed.
  • A disc replacement device is implanted.
  • Normal compression of the spine will hold the implant in place.
  • Surgery takes approximately 1-3 hours.

After the Procedure


  • You will be in the recovery room from 1 to 1½ hours.
  • The surgeon will contact your family while you are in recovery.
  • After going to a hospital room, you will be able to use a PCA pump to get medication for pain control. This machine controls the amount of medication that can be received.
  • Staff will usually get you out of bed shortly after surgery.
  • The hospital stay is usually 1-2 days.
  • A brace or corset may be prescribed for several weeks to prevent excessive bending.
  • You will be given any needed prescriptions and discharge instructions.
  • A set of exercises that you can do at home will be provided.
  • You will be able to ride in a car or plane upon leaving the hospital.
  • Physical therapy is usually initiated after the first office visit with your doctor following surgery.

    • Recovery from ADR varies greatly among patients and is dependent on the extent of the surgery as well as the age and health of the individual. Return to work also varies greatly among patients and is related to overall health and the type of work you do.