Lumbar Total Disc Replacement: Everything You Need To Know

Do you have back pain? If so, you are not alone. Back pain is the most common medical condition affecting 8 out of 10 people during their lives.

There can be many reasons behind your back pain that include degenerated disc, arthritis of joints in the spine, instability, or disc herniation.

Your spine is a set of small bones called vertebrae stacked on top of each other. A disc is present between every two vertebrae that acts as a cushion to allow your vertebrae to move and rotate without rubbing each other. Lumbar total disc replacement is a type of spine surgery in which worn or degenerated discs from the lower part of your spine are replaced with an artificial disc.

Typical lower back pains go away on their own; taking over-the-counter pain relievers, exercising, anti-inflammatory medication, physical therapy, or just taking rest can help you manage your pain. But if your back pain is severe and lasts more than a week, you may need to go through spine surgery.

Why might you need a Lumbar total disc replacement?

Remember, not every patient with lower back pain is a good candidate for a lumbar disc. In general, if you are a candidate for disk replacement, you would have the following characteristics:

• You are experiencing lower back pain due to one or two problematic (arthritic) intervertebral discs in the lumbar spine
• You are not excessively overweight
• You don’t have any significant facet joint disease or bony compression on spinal nerves
• You haven’t undergone any major surgery on the lumbar spine
• You are not having deformity of the spine (scoliosis)
• You are not suffering from osteoporosis

Further, your surgeon may ask you to get a few tests done, including:

• Discography
• Magnetic resonance imaging (MRI) scans
• Computed tomography (CT) scans
• X-rays

The findings from the above tests will help your medical professional determine the cause of your back pain.

Surgical procedure

Lumbar disc replacement surgery may take 2-3 hours to complete. An incision will be made in your abdomen to approach your lower back during the surgery. Then, the blood vessels and organs are moved to the sides to view the disc space better and make room for surgery. An avascular surgeon will assist the orthopedic surgeon while accessing your spine. The surgeon will remove the disc causing the problem and then insert an artificial disc implant into the disk space.

What are artificial discs?

Artificial disc designs are of two types – disc nucleus replacement and total disc replacement. In the case of disc nucleus replacement, only the central portion of the disc known as the nucleus is replaced with a mechanical device, while the annulus (the disc’s outer ring) is not removed. In total disc replacement, complete disk means both annulus and nucleus are replaced to restore the spine’s normal functioning.

Artificial disc prostheses are analogous to the core of the natural disc. They have a movable core, which allows movement in all directions. Unlike former artificial disc prosthesis designed with a non-elastic polyethylene core and suffered from early loosening, the modern discs used in lumbar total disc replacement can support pressure, strain, rotation, and shear.

Before you decide about getting the surgery done, it is advisable to talk to your doctor and get a realistic idea about what you can expect after the surgery. This is important because this spine surgery has only improved the pain in many cases but did not eliminate it. Plus, talk to your doctor about what precautions you would need to take after surgery, what things you can do and what you cannot, how to care for incision, how frequent you would need follow-up with the doctor and so on.