Contraindications to Disc Replacement

The human spine is composed of bones called vertebrae. There are seven cervical vertebrae in the neck, 12 thoracic vertebrae in the upper back, five lumbar vertebrae in the lower back, and nine in the sacrum and coccyx, or tailbone, area. Between each two vertebrae is a disc that acts as a cushion to allow movement in various directions. Degeneration or injury to these discs may require surgical intervention, but in some cases this surgery is contraindicated.

Scoliosis

• Scoliosis is a condition that causes the spine to develop abnormal curvature. Scoliosis typically develops during the growing years around puberty. It ranges from mild to severe and is sometimes a side effect of other medical conditions, such as muscular dystrophy. Spinal disc replacement surgery is contraindicated for people with moderate to severe scoliosis, as the procedure might contribute to the spinal deformity rather than improve spinal alignment. A different procedure, such as a spinal fusion, can be an alternative for these patients.

Osteoporosis

• Osteoporosis is a progressive disease that causes bones to lose density and develop holes. People with osteoporosis are at risk for bone fractures, even from something as otherwise benign as sneezing. Osteoporotic vertebrae are susceptible to compression fractures, and therefore they do not provide a stable base for an artificial disc, so spinal disc surgery is contraindicated for these people.

Infection and Tumors

• Disc replacement surgery is contraindicated for people who have an active infection. Anesthesia affects the lungs' ability to expand, and the presence of infection, particularly in the respiratory system, can cause life-threatening surgical complications. Infection that is present in the area where the surgery will be performed can spread to surrounding structures through the bloodstream, so surgery should be postponed until the infection has cleared. Disc replacement surgery is also contraindicated if tumors are present in the spine or tissues nearby.

Morbid Obesity

• Disc replacement surgery can be contraindicated for people who are morbidly obese. Excess body fat can prevent a surgeon from accessing the spine to insert the artificial disc. Obesity also has a negative effect on functional mobility, which can significantly affect a patient's recovery after spinal disc replacement surgery.

Previous Back Surgery

• People who have had previous spinal surgeries may not be able to have disc replacement surgery. The presence of scar tissue can prevent access to the area in need of repair. In addition, the structural integrity of the vertebrae and intervertebral discs is compromised by the previous surgery.