Artificial Disc Replacement

Artificial Disc Replacement: 

Artificial Disc Replacement (ADR), also known as total disc replacement or disc arthroplasty, refers to a surgical procedure.  The procedure allows surgeons to treat spine conditions by removing a spinal disc and replacing it with an artificial one.  Furthermore, doctors refer to this procedure as Artificial Disc Replacement (ADR). As an example, some of the spine conditions for which it is used include:

Degenerative Disc Disease (DDD):

Degenerative disc disease refers to a common age-related condition characterized by the breakdown of intervertebral discs in the spine. As discs degenerate, they may lose height, hydration, and elasticity.  This leads to decreased disc height, spinal instability, and compression of nearby nerves or spinal cord. Severe cases of DDD that do not respond to conservative treatments may necessitate surgical intervention with ADR to alleviate pain and restore spinal function.

Herniated Disc:

A herniated disc occurs when the inner gel-like nucleus pulposus protrudes through a tear or rupture in the outer annulus fibrosus of the disc. This can lead to compression of spinal nerves or the spinal cord, resulting in pain, numbness, tingling, or weakness. In cases where conservative treatments fail to provide relief, doctors will recommend surgery.  The surgeon will remove the herniated disc and replace it with an artificial implant to maintain spinal stability and function.

Discogenic Back Pain:

Discogenic back pain refers to chronic low back pain originating from the intervertebral discs themselves rather than from nerve compression. Individuals with severe, disabling discogenic back pain that does not respond to conservative therapies may benefit from ADR.  In this case, the diseased disc gets replaced with an artificial one, thereby alleviating pain and preserving spinal motion.

Spinal Instability:

Spinal instability refers to abnormal movement or alignment of spinal segments, often resulting from disc degeneration, injury, or spinal deformities. Severe instability can lead to recurrent pain, neurological deficits, and functional limitations. In such cases, ADR will restore spinal stability, improve alignment, and prevent further degeneration.

Failed Back Surgery Syndrome (FBSS):

FBSS refers to a condition characterized by persistent or recurrent back pain following one or more spinal surgeries. It can result from various factors, including incomplete decompression, adjacent segment degeneration, or hardware failure. In cases where traditional spinal fusion surgery fails to provide relief, ADR will provide a solution for FBSS as well.

Overall, the decision to perform Artificial Disc Replacement is based on a careful evaluation of the patient’s condition.  This includes symptoms, imaging findings, and response to conservative treatments.  An artificial disc is typically recommended for individuals who exhausted nonsurgical options and continue to experience significant pain.

Artificial Discs

Artificial discs consist of medical-grade metals such as titanium or cobalt-chromium alloys.  Additionally, the artificial discs also consist of polymer materials, or from a combination of materials. Some discs feature a ball-and-socket design to mimic the natural movement of the spine.  Others utilize a sliding or hinge mechanism to facilitate flexion and extension.

The longevity of artificial discs varies depending on factors such as the patient’s age, activity level, and overall health.  Of course, the design and materials used in the implant also have a role in the life of the appliance. In general, most artificial discs will last for several decades.  However, the long-term data on their durability is still being collected. Because of the difference in the composition of artificial disc materials, surgeons may choose specific types based on factors such as the patient’s spinal anatomy, the extent of disc degeneration, and the desired range of motion. Additionally, some artificial discs work better for specific regions of the spine to optimize performance and outcomes.

Ultimately, the selection of an artificial disc implant depends on individual patient factors and surgical considerations. Surgeons carefully evaluate the patient’s condition and anatomy to choose the most appropriate artificial disc implant.  The surgeon’s goal focuses on the restoration of spinal function while alleviating pain, and minimizing the risk of complications. By tailoring the choice of artificial disc to each patient’s unique needs and goals, surgeons can optimize the success and longevity of artificial disc replacement surgery.

Surgery

The procedure typically begins with the patient under general anesthesia to ensure comfort and minimize pain. Once the patient becomes sedated, the surgeon makes an incision in the back or abdomen. The surgeon then carefully dissects the surrounding tissues to access the spine and remove the damaged disc.

Next, the surgeon prepares the adjacent vertebrae.  First, the surgeon removes any remaining disc material and shapes the bony endplates to accommodate the artificial disc implant. The artificial disc, made of biocompatible materials, is then inserted into the vacant disc space between the vertebrae.

Complications

While artificial disc replacement is generally considered safe and effective, like any surgical procedure, it carries certain risks and potential complications. These may include infection, bleeding, adverse reactions to anesthesia, implant failure, nerve or spinal cord injury, and adjacent segment degeneration. Patients should discuss the potential risks and benefits of artificial disc replacement with their surgeon.  In addition, they should carefully follow post-operative instructions to minimize the risk of complications and optimize outcomes.

Physical Therapy Recommendations

Physical therapy plays a crucial role in the rehabilitation process following artificial disc replacement surgery.  PT helps restore strength, flexibility, and mobility while promoting proper spinal alignment and posture. Therapeutic exercises, stretching techniques, and manual therapy interventions can help strengthen the muscles supporting the spine, improve the range of motion, and reduce the risk of complications such as muscle weakness or joint stiffness. A personalized physical therapy program tailored to the individual’s specific needs becomes essential for recovery and long-term spinal health.

Prevention Actions

Preventing degenerative disc disease and the need for artificial disc replacement involves maintaining a healthy lifestyle, practicing proper body mechanics, and avoiding activities that place excessive stress on the spine. Regular exercise to strengthen the core muscles, maintain flexibility, and promote spinal health can help reduce the risk of disc degeneration and related complications. Additionally, maintaining a healthy weight, avoiding tobacco use, and practicing good posture can support spinal health and reduce the likelihood of developing degenerative disc disease.

Related Conditions

Degenerative disc disease and the need for artificial disc replacement are linked closely to other spinal conditions.  Those spinal conditions refer to herniated discs, spinal stenosis, facet joint arthritis, and spondylolisthesis. These conditions may coexist or predispose individuals to develop degenerative changes in the intervertebral discs. This highlights the importance of comprehensive medical evaluation and treatment to address underlying spinal pathology and preserve spinal function.

Living with the Condition

Living with an artificial disc replacement requires ongoing management, including regular medical monitoring, adherence to post-operative guidelines, and lifestyle modifications to support spinal health and prevent the recurrence of symptoms. Patients may need to adjust their daily activities, incorporate regular exercise and physical therapy into their routine, and seek support from healthcare providers and support networks to cope with chronic pain and functional limitations.

Long-term Benefits of Treatment and Rehabilitation

With timely diagnosis, appropriate treatment, and diligent rehabilitation, many individuals undergoing artificial disc replacement can experience significant improvement in symptoms and quality of life. By restoring spinal function and mobility, reducing pain, and preventing adjacent segment degeneration, artificial disc replacement offers long-term benefits for individuals affected by degenerative disc disease. Comprehensive rehabilitation programs tailored to individual needs can help optimize recovery, promote spinal health, and enhance overall well-being.

Why Choose the Southwest Scoliosis and Spine Institute

For individuals seeking specialized care for degenerative disc disease and considering artificial disc replacement, the Southwest Scoliosis and Spine Institute offers comprehensive services tailored to individual needs. Led by Doctors Richard A. Hostin, Devish Ramnath, and Ishaq Syed, the institute provides expertise in the management of complex spinal disorders. With offices in Dallas, Plano, and Frisco, Texas, the institute offers state-of-the-art diagnostic, treatment, and rehabilitation services to optimize outcomes and improve the quality of life for patients. The multidisciplinary team of spine specialists at the institute combines advanced surgical techniques, innovative therapies, and personalized care to address the unique needs of each patient, ensuring compassionate and effective treatment throughout their journey to spinal health and recovery. Choosing the Southwest Scoliosis and Spine Institute provides individuals with access to leading experts in spinal care and a commitment to excellence in patient-centered care.

____________________

National Institute of Health: Artificial Disc Replacement