Procedure for Prosthetic Intervertebral Disc Replacement

The discs in the neck and spine provide cushioning for the vertebra and help absorb pressure from spinal movement. When the discs become diseased or damaged, patients often suffer from neck or back pain. Surgeries to remove the discs or surgical spinal fusions are the most common surgical treatments for damaged discs. Spinal fusion can cause loss of flexibility, and the procedure can cause the discs above and below the surgical site to deteriorate more rapidly. Prosthetic intervertebral disc replacements offer an alternative to spinal fusion that can help avoid these problems.

Disc Replacement Surgery

• If traditional pain relief methods, such as physical therapy and medications, have failed to control your back pain adequately, your doctor may suggest disc replacement surgery. You will be under general anesthesia for the procedure so that you will not feel any pain. During the procedure, the surgeon makes an incision in your back to remove the disc that needs replacing. The surgeon inserts two metal plates with spikes on one side into the intervertebral space where the original disc was located after the original disc is removed. The spikes attach to the vertebra above and below the disc space to keep the metal plates in place. New bone will grow over these plates over time. Once the plates are secured, the surgeon will insert a soft plastic prosthetic disc between the plates. Your own body weight will press the prosthetic disc securely between the metal plates after surgery.

Recovery

• Recovery from disc replacement surgery is similar to that of spinal fusion, but it often causes less pain and fewer complications than traditional spinal fusion procedures. Follow your doctor’s instructions exactly to minimize your risk of complications and promote quicker healing. Avoid smoking during the recovery procedure as smoking can delay your healing. You may wear a back brace for several weeks to help limit spinal movement until your spine has had a chance to compress the prosthetic disc fully. Take pain medications as directed, and limit bending, lifting and twisting motions that strain your spine. Most patients go through at least a few weeks of physical therapy. Work with your therapist and perform your exercises faithfully to strengthen your spine.

Risks

• Prosthetic intervertebral discs are made up of many of the same materials as hip and knee replacements. These materials are safe for most patients. Rarely, a patient may have an allergic reaction to the implant materials, resulting in a follow-up surgery to remove the implant. As with all surgeries, there is a risk of bleeding, infection or a negative reaction to the anesthesia. Advise your doctor of any allergies and medications you are currently taking to minimize these risks. Your doctor may tell you to stop taking certain medications, such as blood thinners, prior to surgery. Let your doctor know if your incision appears red or swollen, or if you have a fever, as these could be signs of infection. Other serious, but rare risks of disc replacement surgery include paralysis, tears in the tissue that covers the spinal cord, spinal cord damage and nerve damage.