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Spine Surgery Guide


Total Disc Replacement

What is Total Disc Replacement?

Total disc replacement is an alternative to spinal fusion for some patients. During disc replacement surgery, the surgeon will remove the damaged disc and replace it with an artificial disc. The goal of this and most all spine surgeries is to help to reduce your pain and restore activity. The goal of any artificial disk is to:

The Goal of any Artificial Disk is to:
  • Maintain motion in the area of the spine where the disc is implanted
  • Maintain stability in your spine Restore proper disc height between the vertebrae above and below the disc
  • Re-establish proper spinal alignment / curvature of your spine in the lumbar area
  • Reduce discogenic pain
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When to Consider Total Disc Replacement, and When Not

Disc replacement is a good option to consider in cases of back pain due to a degenerate or damaged disc in the lower back. Disc replacement can certainly be undertaken at one or two levels in the lower back but Mr Boeree would not recommend replacement of more than two discs.

There are some circumstances in which disc replacement would be inadvisable. Movement at the level of the surgery will continue so if the facet joints at the back of the spine are very worn they may give rise to pain. This is one of the reasons why disc replacement may not be a good idea if the disc has become very narrow. In this situation the facet joints are likely to be quite worn. It may be helpful to clarify if the facet joints are causing pain themselves through diagnostic facet joint injections.

The back parts of the spine are essential to help stabilize the disc replacement. If these are damaged or defective disc replacement may be inadvisable. This includes the condition of spondylolisthesis.

The disc replacement needs a strong foundation. If the bone is weak the disc replacement may sink or subside into the bone. Mr Boeree may recommend a check for thinning of the bones (osteoporosis), particularly in women over 50 and men over 55. If there is thinning of the bones in the spine, disc replacement should not be undertaken.

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Suitability for Total Disc Replacement

Disc replacement is an alternative to spinal fusion for some patients. Your eligibility for disc replacement can only be determined by your doctor. Before you and your doctor abroad agree to surgery as an option, your doctor will want to make sure that you've given nonsurgical treatments a reasonable trial. Also, your doctor needs to receive all pertinent medical records such as Xrays, MRIs and in some cases a study called a diskogram, which is a special X-ray examination that involves the use of a dye. The dye, injected into a disk, serves to make it appear better on an X-ray. The injection of dye also may produce a pain similar to your ongoing back pain, which helps your doctor pinpoint that disk as the source of your pain.

Total Disc Replacement Surgery

When undergoing total disk replacement surgery, you will be lying on your back and the surgeon will operate on your spine through an incision near your belly button. The surgeon will remove the diseased disc and replace it with an artificial disk. There are alternative treatments to this surgery. You should discuss these other possibilities with your surgeon before you make your decision.

Total Disc Replacement Recovery

In most cases, immediately after surgery, your heart and lung function will continue to be monitored, and your doctor will prescribe medicines to control pain and nausea. The average hospital stay for disc replacement surgery at our partner hospitals abroad is about ten days, which typically is much longer than what you would receive in the US with the advantage of medically trained people always being close by. Before hospital discharge your doctor will discuss a program to gradually increase your activity. It is possible that you will be asked to wear a back brace or elastic bandage to support your abdominal muscles after surgery.

Life After Disc Replacement

Pain relief, the reduction of further degeneration and resumption of daily activities are typical goals of spine surgery. While both fusion surgery and artificial disc replacement can provide pain relief and stability, with spinal fusion the vertebrae surrounding the disc space are immobilized, and therefore limit flexibility in that area of the spine. Laboratory testing shows that patients who have undergone total disc replacement have more movement in the spine.

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This information is not designed to replace a physician's independent judgment about the appropriateness or risks of a procedure for a given patient.
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