Lumbar Disc Replacement

A lumbar disk replacement is a form of spinal surgery. Your spine is composed of bones called vertebrae that are placed on top of one another. Disks between the vertebrae act as cushions, allowing the bones to rotate and move without rubbing against one another. The lumbar vertebrae and disks are located near the bottom of the spine. Lumbar disk replacement is the process of replacing a damaged or degenerative disk in the lower section of your spine with an artificial disk composed of metal or a metal-plastic composite.

Lumbar disk replacement is widely regarded as an alternative to the more typical spinal fusion surgery. Fusion permanently connects two vertebrae. Lumbar disc replacement is a complex procedure that necessitates general anesthesia and a hospital stay.

Lumbar Fusion V/S Artificial Disc Replacement

Although an estimated 70 to 80% of people may have low back pain at some point in their life, the majority will not require surgery to alleviate their symptoms.

When conservative therapy fails to alleviate low back pain, surgery may be considered; however, not everyone who continues to suffer from pain after exhausting nonsurgical options is a candidate. In addition to being chronic, your discomfort must be caused by one or two degenerative (arthritic) disks, as verified by diagnostic tests and physical examination.

For individuals who match these (and other) criteria, lumbar fusion surgery is still the most popular therapy for low back pain. Fusion is a welding technique. The main concept is to fuse the damaged vertebrae so that they recover into a single, solid bone, hence preventing uncomfortable motion.

While lumbar fusion benefits many individuals, the outcome of the procedure varies. Furthermore, even when fusion operations heal completely, some patients' back discomfort does not improve. The success rate for lumbar fusion for low back pain caused by a degenerative disk is between 50 and 90 percent.

Some clinicians feel that the inability to recover following fusion surgery is because fusion restricts natural spinal mobility. As a result, artificial disk replacement, which tries to maintain normal mobility, has emerged as a viable therapeutic option for low back pain.

Artificial disk replacement received FDA clearance for usage in the United States in 2004. Since then, several disk replacement designs have been created, and more are being tested.

Why would I need to have my lumbar disk replaced?

The primary reason you would require a lumbar disk replacement is to alleviate low back discomfort. However, not everyone with low back discomfort is a good candidate for lumbar disk replacement surgery.Your doctor will need to do certain tests to see if this is the best option for you.

• Lumbar disk replacement surgery may be recommended
• If your back pain is primarily caused by one or two disks in your lower spine,
• There is no significant joint disease or nerve compression,
• You are not overweight,
• You have not had previous spinal surgery,
• You do not have scoliosis or another spinal deformity.

You may be a candidate for disk replacement surgery if the following are true:

• You are not overweight.
• The issue is limited to one or two levels of your spine, not affecting other places.
• Your spine joints have little arthritis.
• No previous spine surgery.
• No significant pressure on spinal nerves.

Surgical procedure

Most artificial disc replacement operations last 2 to 3 hours.
Your surgical team will access your lower back from the front via an abdominal incision. Organs and blood vessels must be relocated to the side when using this method. This enables your surgeon to reach your spine without disturbing the nerves.
During the operation, your surgeon will remove the damaged disk and install an artificial disk implant into the empty area.

Potential complications

• Requires extra surgery to remove or replace the implant.
• Allergy to implant materials
• Bleeding or blood vessel issues
• Bending, breaking, loosening, or moving implants
• Incision issues, including infection
• Male sexual dysfunction
• Pain or discomfort.
• Side effects of anesthesia
• Slow intestinal motility
• Damage to the spinal cord or nerves
• Fluid leaking or rips in the dura (the layer of tissue surrounding the spinal cord).

Recovery

In most circumstances, you will be in the hospital for 1 to 3 days following artificial disk replacement. The length of your stay will be determined by how effectively your pain is managed and your ability to function.
In most situations, patients are advised to stand and move on the first day following surgery. Because bone fusion is not necessary during artificial disk replacement,The average patient is advised to pass via the midsection. Early mobility in the trunk region may result in speedier healing and recovery. Excessive motion should be avoided, however, because your bone must repair to the prosthetic disk. Your doctor will discussthis with you about limits.
During the first several weeks following surgery, you will practice simple workouts such as normal walking and stretching. During this period, you should avoid doing anything that causes you to hyperextend your back.

Outlook (prognosis)

The risk of problems is minimal following lumbar disk replacement. The operation frequently improves backbone mobility more than other spinal surgeries. It is a safe treatment that provides pain relief shortly after surgery.The risk of spinal muscle (paravertebral muscle) damage is lower compared to other forms of spine surgery.