From the Research
Intervertebral Disc Replacement (IDR) surgery is a procedure where a damaged spinal disc is removed and replaced with an artificial disc, typically recommended for patients with severe disc degeneration or herniation who haven't responded to conservative treatments. This surgery is designed to maintain spinal motion, unlike fusion surgery which eliminates movement between vertebrae. The decision to undergo IDR surgery should be based on a thorough evaluation of the patient's condition, including the severity of disc degeneration, the presence of any other spinal conditions, and the patient's overall health status 1.
Key Considerations
- The artificial disc is designed to preserve normal spine biomechanics, potentially reducing stress on adjacent discs and lowering the risk of adjacent segment disease that can occur with fusion procedures.
- Recovery typically takes 4-6 weeks, with patients often able to return to light activities within 1-2 weeks post-surgery.
- Pain medication management usually includes NSAIDs like ibuprofen (600-800mg every 6-8 hours) or naproxen (500mg twice daily) for 1-2 weeks, with stronger medications like oxycodone (5-10mg every 4-6 hours) prescribed for severe pain in the first few days.
- Physical therapy is crucial for optimal recovery and typically begins 2-4 weeks after surgery, focusing on strengthening core muscles and improving flexibility.
Potential Complications
- Implant migration
- Wear
- Infection
- Nerve injury Although these risks are relatively low with modern techniques and proper patient selection, it is essential to carefully weigh the potential benefits and risks of IDR surgery on a case-by-case basis 2, 1.
Long-Term Outcomes
A study published in 2017 found that patients who underwent IDR surgery had significant improvements in physical function, pain, and quality of life compared to those who received multidisciplinary rehabilitation, with a mean difference of 6.1 points on the Oswestry Disability Index (ODI) at 8-year follow-up 1. However, the difference between groups was smaller than the prespecified clinically important difference of 10 ODI points, highlighting the need for further research to improve selection criteria for IDR surgery.