Our team has also compiled some of the most commonly-asked questions about the process of having your disc replaced — we hope this helps with any questions you may have about the process.
What is lumbar disc replacement?
Lumbar disc replacement surgery is also known as lumbar total disc replacement (LTDR), artificial disc replacement (ADR), or disc replacement surgery. Lumbar disc replacement is intended to relieve disabling low back pain, with or without leg pain by replacing damaged or diseased discs with an artificial disc. These discs are often made of metal in combinations with medical-grade plastic. Lumbar total disc replacement replaces both the annulus and the nucleus of the disc. The artificial disc is designed to mimic the form and function of the spine’s natural disc allowing for more natural motion
What are the benefits of lumbar disc replacement?
The benefits of lumbar artificial disc replacement include:
Where is lumbar disc replacement performed?
Lumbar disc replacement can be performed in the lumbar spine including L5-S1. Disc replacement is not performed in the thoracic spine.
Can you have more than one lumbar disc replacement?
Yes, lumbar disc replacement can be performed at multiple levels. Single level lumbar disc replacement was FDA approved October 2004; Two level lumbar disc replacement was FDA approved in April 2020. Surgeons at the Center for Disc Replacement at THCDS have performed hundreds of multiple level lumbar disc replacements, some involving more than 2 levels.
Are lumbar disc replacement implants FDA approved? Which implant will my doctor use?
Yes, there are several FDA-approved disc replacement devices available in the U.S. It’s important to discuss what device options are appropriate for you, as there are several factors a surgeon considers when determining which device to use. The physician will determine which implant is appropriate for you by examining your spinal anatomy, vertebrae size, disc height, and overall spinal stability
How do I know if I qualify for lumbar disc replacement surgery?
Some of the common conditions that may make you a candidate for disc replacement surgery include the following characteristics:
- Lower back pain with or without leg pain (and arm pain for cervical)
- Conservative treatment without significant relief of pain
- Degenerative disc disease
- Herniated lumbar discs or recurrent herniated discs
- Previous disc surgery with continued pain
- Being told you should have a fusion
I was told I need I fusion how do I know if I am a lumbar disc replacement candidate?
If you are interested in finding out if you are a good candidate for this procedure, you should get a second opinion. It’s important to discuss artificial disc replacement surgery with a surgeon experienced in both fusion and disc replacement surgery to determine if you are an appropriate candidate for disc replacement surgery.
Are there any conditions that lumbar disc replacement will not work for?
Yes, not everyone with back pain is a disc replacement candidate. The causes behind back pain can be quite complex and interconnected across the disc and surrounding bone. In some instances, fusion may still be the preferable option. For examples, conditions such as scoliosis, ankylosing spondylitis, spinal fractures or significant facet joint disease may not qualify for disc replacement. It is also not recommended for patients with previous spinal surgery complications, autoimmune disorders, metal allergies or patients who are morbidly obese.
Can I have a lumbar disc replacement if I have a metal allergy?
If you think you have a metal allergy or nickel allergy you should let your surgeon know at your consult so you can be tested. If you have a metal allergy to nickel, you cannot have a lumbar disc replacement because the currently available lumbar implants contain small amounts of nickel.
What is the recovery process like after lumbar disc replacement?
Most patients will require a hospital stay of 1 or 2 nights after surgery. Patients are usually standing and walking within hours of surgery and are frequently completing basic exercises by the end of the first few weeks. Most people will start physical therapy after few weeks, and many people return to non-strenuous work after a few weeks.
During recovery, it is important to avoid any activities that may cause you to hyperextend your back, such as engaging in improper lifting, repetitive movements, and certain exercises or activities. A wide belt-type brace is provided to allow the surgical incision to heal as well as to remind you to limit motion for the first few weeks to allow the artificial disc to heal to your spine.
Is lumbar disc replacement covered by insurance?
Yes, single-level lumbar replacement is now covered by most insurance plans. There are some plans that do not cover lumbar disc replacement, such as Medicare and Medicaid. You should contact your insurance company to learn more about your specific coverage.