From the Guidelines
The spine surgery called for replacing discs is known as artificial disc replacement (ADR) or disc arthroplasty, also referred to as total disc replacement in the context of lumbar spine fusion comparisons. This procedure involves removing a damaged or degenerated intervertebral disc and replacing it with an artificial disc device made of metal and plastic components designed to mimic the function of a natural disc. According to a recent umbrella review of level 1 evidence published in the BMJ in 2021 1, total disc replacement has been shown to significantly improve pain and patient satisfaction, reduce reoperation rate and operation time, shorten duration of hospital admission, and decrease post-surgical complications compared with lumbar spine fusion in both the short term and the long term.
- The surgery aims to preserve motion at the treated spinal segment, unlike spinal fusion which eliminates movement between vertebrae.
- ADR is typically performed on the cervical (neck) or lumbar (lower back) spine for patients suffering from degenerative disc disease who haven't responded to conservative treatments like physical therapy, medication, or injections.
- The procedure requires general anesthesia and typically involves an anterior (front) approach to the spine.
- Recovery varies by individual but generally takes several weeks to months, with patients often able to return to light activities within a few weeks.
- ADR offers potential advantages over fusion including maintaining spinal mobility, potentially reducing stress on adjacent discs, and possibly decreasing the risk of adjacent segment degeneration over time, as suggested by the comparison between lumbar spine fusion and total disc replacement in the review 1.
From the Research
Spine Surgery for Disc Replacement
- The spine surgery where you replace discs is called Total Disc Replacement (TDR) surgery 2, 3, 4, 5.
- TDR is an alternative to spinal fusion surgery for treating lumbar degenerative disc disease (LDDD) 2, 3, 4, 5.
- The goal of TDR is to preserve motion in the spine, whereas spinal fusion surgery involves fusing two or more vertebrae together 3, 4, 5.
Types of Total Disc Replacement
- There are different types of artificial discs used in TDR surgery, including the Charité artificial disc and the Prodisc artificial disc 2.
- The choice of artificial disc depends on the individual patient's needs and the specific condition being treated 2, 3, 4, 5.
Effectiveness and Safety of Total Disc Replacement
- Studies have shown that TDR is an effective treatment for LDDD, with improved outcomes compared to spinal fusion surgery in some cases 3, 4, 5.
- TDR has been shown to have a lower risk of complications, such as blood transfusions and neurologic complications, compared to spinal fusion surgery 6.
- However, the long-term effectiveness and safety of TDR are still being studied, and more research is needed to fully understand its benefits and risks 2, 3, 4, 5.