Artificial disc replacement is a surgical procedure in which a degenerated disc in the spine is replaced with a mechanical device that substitutes as an artificial version in an effort to restore motion. It is most commonly performed to treat degenerative disc disease or post-laminectomy syndrome in patients who do not have advanced facet joint disease or scoliosis. Artificial disc replacement may be recommended when severe lower back pain is not resolved by more conservative therapies such as physical therapy and medication, and the disk degeneration affects only one or two vertebrae.
The outer portion of discs can tear over time with age, resulting in degenerative disc disease. When the jelly-like substance inside the disc begins to dry out, it “bulges,” creating pressure against the nerve root. This pressure can sometimes cause severe pain in the lower back.
During an artificial disk replacement, the patient is placed under general anesthesia. Commonly, a vascular surgeon or specially trained general surgeon assists the neurosurgeon with making an incision in the abdomen to access the spine from the front (anterior), carefully preserving abdominal structures.
Small instruments are used to remove the damaged disk before the endplates are implanted to the adjacent vertebrae to hold the artificial disk in place. Once the mechanical device is placed, the incision is closed. The surgery typically takes three to four hours.
Once surgery is complete, most patients will remain in the hospital for two to four days for monitoring and treatment of post-surgical pain with medication. Patients are encouraged to begin walking in the hospital with assistance as soon as possible after recovering from the anesthesia. It is normal for continued pain immediately after surgery, particularly around the incision. Outpatient physical therapy or a self-directed rehabilitation program will be prescribed upon discharge.
The surgeon will coordinate a specific postoperative recovery plan for patients, based upon the type of work they perform and their presurgical activity level. Patients are encouraged to increase their activity level gradually. Discomfort is normal after surgery, but pain is a sign that the body needs to stop and rest. Recovery times vary for every patient, but on average, patients return to regular activity between six and eight weeks.
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