If you’re considering spinal surgery to relieve back pain, you owe it to yourself to consider the option of artificial disc replacement surgery.
Disc replacement surgery is a relatively new procedure, developed in the last 25 years in the U.S. for treating herniated discs in the lower back (lumbar spine) as well as the neck area (cervical spine).
“Disc replacement surgery involves removing a painful or damaged disc and replacing it with a synthetic disc that replicates the motion of a normal disc,” said Dr. Scott Blumenthal, a spine surgeon on the medical staff at Texas Health Center for Diagnostics & Surgery in Plano, Texas.1
“Both cervical disc replacement and lumbar disc replacement can alleviate pain and preserve the range of motion in the affected area of the spine.”2
In cervical disc replacement, a small incision is made at the front of the patient’s neck. The important structures of the neck are carefully moved to the side so that the surgeon can see the vertebrae and the cervical disk. The affected cervical disk is removed, and the artificial disk is then secured into the empty disk space.
Artificial disc replacement in the lumbar spine is also done from the front of the spine, through the abdomen. Accessing the spine through the abdomen allows the surgeon to avoid disturbing the spinal nerves. The organs of the abdomen and blood vessels are moved to the side so that the surgeon can see the backbone. Next, the surgeon removes the damaged portion of the disk and inserts a new artificial disk in its place.3
In contrast to more invasive procedures, such as spinal fusion, disc replacement recovery is typically easier and quicker for most patients.
“With lumbar disc replacement, we typically have our patients up out of bed and walking within an hour or so after surgery,” said Dr. Blumenthal. “Eventually they'll progress from just walking to a physical therapy rehabilitation program. By about three months after the surgery, they can usually return to normal activities.”4
A Center of Excellence
As many patients know, when considering a complex procedure, it’s important to seek out a surgeon and a surgical center with the most experience in that type of surgery. That’s especially important for surgery involving new or evolving surgical techniques, like artificial disc replacement.
That advice has led many patients from around the U.S. to find their way to Texas Health Center for Diagnostics and Surgery (THCDS) for artificial disc replacement surgery.
“Patients with tough medical situations will do a Google search to find the surgical center with the most experience, and they find us,” said Dr. Blumenthal.
Dr. Blumenthal performed the first artificial disc replacement procedure in the United States in March 2000. Since then, THCDS spinal surgeons have performed more than 3000 surgical disc replacements, using more than 14 different types of implanted devices.
Surgeons at THCDS remain at the forefront of artificial disc replacement surgery, refining their techniques and participating in research to develop advances and improvements.
“One of the most exciting developments is that we have found that many more patients are candidates for cervical disc replacement than we originally anticipated,” Dr. Blumenthal said.
Surgeons at THCDS have also accumulated experience using a variety of replacement devices.
“There are new discs out now that have better properties in terms of how they appear in imaging on MRI scans,” said Dr. Blumenthal. “We also have more options, such as discs in different sizes for smaller patients and discs that use different biomaterials, each with specific advantages.
“This field is really evolving, and we’re proud to be on the forefront of these advances because we've participated in many of the FDA trials for the newer discs that are coming to the market now.”5
Revision Surgery
Many patients have also sought out THCDS surgeons for revision surgery.
“Revision surgery” is a second surgery, performed after an initial spine surgery, either due to failure of the initial procedure or other long-term issues that emerge after spinal surgery. It’s typically even more complex than the first-time procedures for replacing a damaged disc with an artificial disc.
“Unfortunately, every technology has a failure rate,” said Dr. Blumenthal. “For example, 10 years after the development of total hip and knee replacement surgery, surgeons developed techniques to perform revision surgery for hips and knees. Similarly, now that we're 20 years after the development of disc replacement in the U.S., we're seeing patients from all over the country, because a small percentage of discs, particularly in the cervical spine, need to be revised.”
Dr. Blumenthal adds that, when artificial disc technology first emerged, surgeons expected they would perform spinal fusion surgery in those rare cases where the replacement disc failed. (Spinal fusion involves connecting two bones of the vertebrae — helping alleviate pain but reducing mobility between the two vertebrae.) That’s changed, too.
“Now we've got a tremendous amount of experience in doing revision disc replacement — in other words, taking out an artificial disc in the cervical area and putting in a newer generation or better-fitted disc replacement for the patient,” he said.6
“Since that first procedure in 2000, we’ve tracked how patients are doing with their replacement discs,” he said. “For the first few thousand procedures we performed, the revision rate was about 1%, which is considerably lower than the revision rate for hip and knee replacement surgery. So it's a small percentage, but given the large number of disc replacement surgeries that are being done now, the number of people who need revision is increasing, and we’ve become the center of excellence for that revision surgery, too.”
This is general information for educational purposes only. You should discuss your symptoms with your provider.
[1] Blumenthal video: How is disc replacement surgery performed?
https://www.youtube.com/watch?v=Fiur6z0uCOU
[2] From Blumenthal video: What is lumbar and cervical disc replacement surgery?
https://www.youtube.com/watch?v=5Y5-oY5ZCLY
[3] From Blumenthal video: What is lumbar and cervical disc replacement surgery?
https://www.youtube.com/watch?v=5Y5-oY5ZCLY
[4] From Blumenthal video: What is the recovery process like for lumbar disc replacement?
https://www.youtube.com/watch?v=QMOf8aYPPwI
[5] From Blumenthal video: What’s new in Artificial Disc Replacement technology?
https://www.youtube.com/watch?v=xVf_T73HC_g
[6] Blumenthal video: What’s new in Artificial Disc Replacement technology?
https://www.youtube.com/watch?v=xVf_T73HC_g