Artificial disc replacement is a relatively new surgical procedure used to replace a damaged spinal disc in your neck (cervical spine) or lower back (lumbar spine) with a manmade substitute. Doctors developed the procedure as an alternative to a type of surgery called spinal fusion. While artificial disc replacement comes with its own set of potential risks, it avoids many of the risks associated with spinal fusion.
When one of the cushioning discs in your spinal columns gets damaged or deteriorates, it can trigger levels of pain and discomfort that range from minor to severe. While doctors use nonsurgical treatment options to ease relatively minor disc symptoms, people with severe symptoms sometimes need surgery to reduce their pain levels and improve their daily back function. In some cases, surgery involves the removal of one or more entire spinal discs, and the resulting gap in the spinal column can lead to dangerous degrees of back instability. Until recently, doctors had to rely on spinal fusion—a procedure that fills this gap by gradually encouraging the growth of new bone material—to address any instability.
Basics of the Procedure
Conventional artificial spinal discs can be made from a variety of materials, including forms of metal called titanium alloy and cobalt chromium, and a form of plastic called polyethylene. Some discs contain only metal, while others have a plastic core sandwiched between metal end pieces. Whatever the materials used, each replacement disc is designed to promote normal spinal function by allowing the end pieces to move freely around the disc’s core, absorbing shock like a natural disc and maintaining proper spacing in your spinal column.
Replacement takes place immediately after your surgeon removes a damaged spinal disc. During most procedures, the end pieces of the artificial disc are anchored to the bone above and below the surgical site. Over time, new bone growth will cover these portions of the disc, while the disc’s core remains free to move as needed. In a more experimental form of disc replacement, the outer covering of the natural disc is left intact while the surgeon replaces the soft disc interior with artificial cushioning material.
Benefits of the Procedure
When used in carefully selected patients, artificial disc replacement can lead to significant reductions in back or neck pain, as well as considerable improvements in quality of life. Most suitable candidates for the procedure have only a single damaged spinal disc, have not undergone a previous major back procedure, are not obese, don’t have other nerve-related spine problems, and don’t have scoliosis or any other type of major spinal deformity. Artificial disc replacement also sidesteps many of the complications associated with spinal fusion, including damaging stress on the spine above and below the surgical site, significantly reduced spinal flexibility and mobility, and altered body mechanics that can lead to future problems with normal movement.
Risks of the Procedure
Although doctors and medical researchers have been investigating artificial disc replacement for more than 40 years, they have only developed reliable forms of the procedure in the last few years, and the U.S. Food and Drug Administration has only approved artificial discs relatively recently. For this reason, there is not much available information on the long-term results of the procedure. Apart from the risks associated with any form of major back surgery, specific risks associated with artificial disc replacement include failure or breakage of the materials used to build the disc, unwanted displacement of the disc in your spinal column, and failure to improve your back-related symptoms.