Artificial disc replacement is an alternative treatment for degenerative disc disease that is becoming increasingly popular in the United States. However, not everyone is a candidate for this procedure.
Generally, people who have had previous spinal surgery, progressive neurological disorders, infection in the spine, severe facet joint arthritis, extremely high or low body mass index, or active cancer are not candidates for artificial disc replacement.
In addition, individuals with extreme disc herniation, disc extrusion, or severe instability in their spine may also not be suitable candidates. Ultimately, the patient’s overall health, medical condition, and medical history need to be assessed by an orthopedic spine surgeon in order to determine if an artificial disc replacement is the right course of treatment.
When is disc replacement not an option?
Disc replacement is not an option in certain situations where more extensive spinal problems are present, such as nerve damage, severely damaged vertebrae, or spinal tumors. When one or more vertebrae have fractured or when there is significant compression of the spinal cord due to the disc degeneration, the disc cannot be replaced and a spinal fusion surgery is a more appropriate treatment.
Additionally, disc replacement surgeries are not usually recommended for patients under the age of 50 without a very compelling reason, due to the fact that the disc replacement technology is still relatively new and the long-term effects of the surgery are still unknown.
In some cases, where the spinal anatomy is not ideal, or if there is an infection present, disc replacement may not be appropriate. Patients with conditions such as scoliosis or osteoporosis are usually not candidates for disc replacement surgery because these diseases often affect the spinal vertebrae in ways that make it difficult or impossible to place new discs in the proper location.
In addition, if the bones of the spine are too weak, or if there is too much instability in the spinal column, disc replacement may not be possible.
Can you have a disc replacement after a fusion?
Yes, it is possible to have a disc replacement after a fusion. A disc replacement is a procedure in which a damaged intervertebral disc between two vertebrae is removed and replaced with an artificial disc.
After a fusion, which involves fusing two or more vertebrae together to provide arch stability, a disc replacement may be performed if the vertebrae become weak due to the fusion or if there is ongoing pain or mobility issues.
It is important to talk to your doctor for an individualized assessment to determine if a disc replacement is a good option for you after a fusion.
How do you avoid surgery if you have a lumbar herniated disc?
If you have a lumbar herniated disc, there are a number of non-surgical treatments available to help reduce the pressure on the disc, manage your pain, and increase mobility. These treatments can include:
• Physical therapy: Exercises and stretches designed to strengthen your core and improve flexibility and coordination can help reduce pain, improve range of motion and build your confidence.
• Non-steroidal anti-inflammatory drugs (NSAIDs): Over-the-counter medications such as ibuprofen and naproxen can reduce pain and inflammation.
• Muscle relaxants: Muscle relaxants may be prescribed to help reduce tension in the back and lessen the stress placed on the herniated disc.
• Hot and cold therapy: Alternating ice and heat on the affected area can help reduce pain and inflammation.
• Lifestyle modifications: It’s important to maintain a healthy weight, practice proper posture and use ergonomically correct furniture to support your back; all of these can help reduce your risk of future injury and lessen symptoms.
• Epidural steroid injections: Injections of corticosteroids directly into the epidural space can reduce inflammation and lessen pain in the lower back.
• Complementary therapy: Massage, acupuncture, and chiropractic care can help to reduce pain, improve range of motion and reduce stress.
By talking to your doctor and trying these non-surgical treatments, you can often successfully treat a lumbar herniated disc and avoid the need for surgery.
When is surgery contraindicated?
Surgery is not always an appropriate treatment option and may be contraindicated in certain medical conditions and situations. Surgery may be contraindicated if the patient is deemed to be at too high of a risk for complications due to their medical history or underlying disease processes, or if the proposed surgery would not provide any significant benefit to the patient.
Surgery may also be contraindicated in cancer and malignant tumors, as there is often no “cure” to the illness, and some treatments may lead to metastasis. Surgery may also be contraindicated in conditions with unstable vital signs, in cases where a delay in the procedure would be fatal, in terminal illnesses and when any surgery would be considered excessively risky or inhumane.
Therefore, it is important to discuss the risk-benefits of any proposed surgery with the patient and their healthcare team before making any decisions.
What should I avoid with a L5 S1 herniated disc?
If you have a herniated disc at L5-S1, you should avoid activities that put pressure on your lower back and spine, such as lifting heavy objects, twisting, bending over, and any other strenuous activities that can cause pain or irritation to your back or spine.
You should also avoid contact or high-impact sports like football as well as activities that may put your body into unnatural positions.
Your doctor may give you specific instructions on how to adjust your daily life according to your injury, but in general, you should start with some low-impact exercises like swimming, low-impact aerobics, and walking to get some movement into your spine and help your herniated disc heal.
Any activities that you do should be done in moderation, since overdoing them could put too much pressure on your back and further injure your spine.
Other than physical activities, you should avoid sitting for extended periods of time, as this can cause further back pain and discomfort. If you must sit for long periods of time, make sure to take regular breaks to get up and walk around to reduce pressure on your lower back.
You should also practice good posture, making sure to keep your head, shoulders and back in alignment when sitting.
It is also important to manage your stress levels and get adequate rest. Stress can have a negative impact on the healing process, so make sure to practice relaxation techniques like yoga or meditation to reduce stress and get the best rest possible.
In sum, if you have a L5-S1 herniated disc, it is important to avoid physical activities that could put stress on your spine, as well as activities like sitting for long periods of time, practicing poor posture, and having inadequate rest and high stress levels.
By adjusting your daily activity and lifestyle you can help your herniated disc heal properly.
Is surgery the only option for bulging discs?
No, surgery is not always the only option for bulging discs. Many treatment options exist to help manage the condition, such as physical therapy, medications, activity modifications, chiropractic care, and alternative therapies such as acupuncture.
Surgery should be considered only after more conservative treatments have been exhausted and when the symptoms cannot be adequately controlled with less invasive methods. In some cases, a bulging disc can heal on its own after a few weeks of observation and simple treatments.
However, bulging discs that are causing severe pain, radiculopathy (pain radiating along a nerve), or muscle weakness may need to be surgically corrected.
What is the failure rate of artificial disc?
The failure rate of artificial disc replacement (ADR) varies depending on the type of device used, the affected level of the spine, and other factors such as the patient’s age and body mechanics. Artificial discs typically have a success rate ranging from 93 – 98%, when used to treat degenerative disc disease at one single level.
Studies have found that the failure rate for the Prestige LP and Maverick artificial disc, two of the most commonly used artificial discs, after five years of use, was approximately 2%. In addition, the failure rate for the Prodisc L artificial disc was 2% after 3 years of use.
Further, a study published in the Journal of Neurosurgery: Spine on the clinical outcomes of artificial disc replacement found a failure rate of 9. 1% after 5 years of use. This included pseudarthrosis, retear, changes of adjacent segments, device dislocation, fracture, and other major complications.
Overall, artificial disc replacement has been regarded as a successful orthopedic procedure but it is important to note that, like many other medical procedures, it may not work as expected in some patients.
It is important that potential patients consult with an experienced spine surgeon to determine if artificial disc replacement is an appropriate treatment option.
How do you know if you need a disc replacement?
Although it is important to consult a physician to verify any diagnosis. If the disc has been damaged due to a traumatic injury, such as a fall or car accident, then you may need to consider disc replacement surgery.
It is also possible that you are experiencing symptoms due to a degenerative disc disorder, such as age-related disc wear and tear or bulging discs. You may also be experiencing chronic pain or nerve-related symptoms, such as tingling, numbness, and radiating pain in the arms or legs.
In these cases, it may be beneficial to have a conversation with your doctor about the possibility of a disc replacement. Ultimately, your doctor will be able to examine you and make a determination if an artificial disc replacement is the best treatment option for your condition.
Are disc replacements worth it?
Whether or not disc replacements are worth it really depends on the individual situation. Disc replacements can help relieve pain and improve function in cases of severe disc degeneration, often without the need for fusion surgery.
However, they do require a longer recovery period than fusion surgery, and patients may still need additional treatment to fully recover. It is important to discuss the options with your doctor, as your particular circumstances may influence their decision over which treatment plan is the most beneficial.
In general, disc replacements can help preserve motion in the spine and alleviate symptoms of back pain and sciatica that may be caused by disc degeneration. Furthermore, patients who have undergone a disc replacement may return to normal activity more quickly than if they had undergone fusion surgery, as the motion of the spine is not limited as much with replacements.
Ultimately, the decision over whether or not a disc replacement is worth it all depends on the individual patient’s needs.
How long do disc replacements last?
The longevity of disc replacements will depend on the individual and the materials used in the procedure. In most cases, your prosthetic disc is designed to last for at least 10 years. In some cases, a disc replacement may last even longer with proper maintenance.
Studies have shown that up to 93 percent of individuals remain satisfied with their disc replacements after 10 years.
Patients who have disc replacements will need to continue to maintain a healthy lifestyle and regular exercise to help ensure a long-lasting outcome. It is also important to follow up with regular visits to your doctor to evaluate your restoration progress as well as check for any signs of deterioration.
If deterioration occurs, your physician will be able to help adjust your lifestyle and treatments to help ensure a healthier outcome.
Lastly, the materials used in a disc replacement will also play a role in the longevity of the implant. Disc replacements made out of titanium alloy, for example, tend to last longer than those manufactured using prosthetic material substitutes.
In summary, the longevity of disc replacements will vary from person to person, but with proper maintenance and regular check-ups, many people can expect a disc replacement to last for 10 years or more.
What does a damaged disc feel like?
A damaged disc feels like an uneven area on the surface of the disc. If you run your finger over the affected area, it might feel raised or have an odd texture. Other signs of a damaged disc include cracking around the perimeter of the disc, warping, or physical damage such as scratches and scuffs.
If you deploy a magnifying glass, you might spot fine scratches on the playing surface. To check for playable damage, try scratching the surface of the disc with a soft cloth from the center outward.
If any of the material from the disc gets onto the cloth, the disc is likely damaged beyond being playable.
