Total Disc Replacement Surgery
When the intervertebral discs of the human spinal cord, those that sit between each vertebra, sustain significant damage or become diseased, surgical intervention becomes a necessity. Intervertebral discs serve various functions which include shock absorption, movement assistance, and supporting the structural integrity of the spine. As such, when these functions are diminished the patient experiences a dramatic drop in his or her quality of life and is vulnerable to a number of serious, acute and chronic conditions.
For many years the only viable surgical option to treat damaged or diseased spinal intervertebral discs was a procedure called Spinal Fusion. During a Spinal Fusion procedure, the surgeon would typically remove all the damaged intervertebral tissue and “fuse” the, now empty, space between the bones. Spinal Fusions are effective in limiting vertebral movement and increasing vertebral stability. However, Spinal Fusion does carry a degree of risk and certain side effects such as post-operative pain and swelling, which can lead to prolonged recovery.
Thankfully, a relatively new procedure is gaining traction across the medical community which is just as capable of restoring a patient’s quality of life as the more traditional Spinal Fusions but without many of the drawbacks associated with Spinal Fusion. Total Disc Replacement surgery has become the go-to alternative for patients with severely damaged or diseased discs.
During Total Disc Replacement, the surgical team replaces the damaged tissue with an artificial disc. This advanced treatment method provides patients with significant relief of symptoms while preserving a high range of intervertebral motion.
Indications & Contraindications
The Total Disc Replacement procedure is a viable option for patients that have not responded positively to non-surgical options. However, the procedure is not a solution to all ailments of the spine, and therefore a careful examination of the patient’s current condition and clinical history must be made.
Patients who are suffering from severe back pain due to some form of degenerative disc disease are prime candidates for the procedure. On the other hand, patients who are pregnant or are suffering from osteoporosis, vertebral osteomyelitis, fractured vertebrae, spinal tumors, spondylolisthesis, and obesity are not viable candidates.
Total Disc Replacement surgery is a major operation, and like many major operations, it must be performed under the effects of general anesthesia. The most common entry point through which the surgical team will operate will be through the abdomen. Using the latest in imaging technology and modern medical advancements, the surgeon carefully removes the damaged or diseased disc. Once done, the surgeon thoroughly cleans and prepares the intervertebral space before implanting the artificial disc. Once in place, the surgeon realigns all the vertebrae to ensure minimal displacement and disruption to the spine.
The surgery should not last longer than 3 hours and the postoperative recovery period is relatively short. Most patients who undergo a Total Disc Replacement surgery will typically be able to go home after four days. Like with all major surgeries, a course of antibiotic and pain medications are prescribed along with a variety of physical therapy exercises designed to promote optimal healing and restore the patient’s full range of motion and physical capabilities. Rest and a nutrient rich diet are also critical to achieve a complete and quick recovery. Patients should be careful at this time to avoid lifting heavy objects or bending at the waist. A full recovery can usually be expected after 2 to 3 months.
Risks & Complications
Complications associated with Total Disc Replacement surgery align with those of other forms of spinal surgeries and include:
- The risk of bacterial infection
- Vascular trauma or injury
- Vertebral dislocation
- Nerve damage
- Increased pain
- Sexual dysfunction
Total Disc Replacement surgery offers the majority of patients a highly promising path to recovery of full spinal function. Although there is the potential for risks, the great majority of patients experience significant benefits either without side-effects or that far outweigh any risk factors.