Lumbar disc replacement surgery
A lumbar disc replacement is a type of back or spine surgery. The spine is made up of bones called vertebrae that are stacked on top of each other. Discs between the vertebrae act like cushions to allow the vertebrae to rotate and move without the bones rubbing against each other. The lumbar vertebrae and discs are at the bottom of the spine. Lumbar disc replacement involves replacing a worn or degenerated disc in the lower part of the spine with an artificial disc made of metal or a combination of metal and plastic. The goal of the procedure is to relieve back pain while maintaining more normal motion than is allowed with some other procedures, such as spinal fusion.
Lumbar fusion and artificial disc replacement
It is estimated that 70% to 80% of people will experience low back pain at some point in their lives, however most will not need surgery to improve their pain. Surgery is considered when low back pain does not improve with conservative treatment.
For patients who have exhausted nonsurgical options and are still in pain, lumbar fusion surgery remains the most common option for treating low back pain. The basic idea is to fuse together the painful vertebrae so that they heal into a single, solid bone.
While many patients are helped by lumbar fusion, the results of the surgery can vary. In addition, some patients whose fusion surgeries heal perfectly still end up with no improvement of their back pain. Artificial disc replacement has emerged as an alternative treatment for low back pain with the aim to preserve normal motion unlike spinal fusion which prevents normal motion in the spine.
Indications of lumbar disc replacement surgery
In general, lumbar disk replacement surgery might be recommended if:
- the back pain mostly comes from only 1 or 2 disks in the lower spine
- there is no significant joint disease or compression on the nerves of the spine
- body size is not excessively overweight
- there has been no prior major surgery on the lumbar spine
- there is no deformity of the spine (scoliosis)
Risk associated with lumbar disc replacement
Like all surgeries, lumbar disc replacement poses some risks. A disc replacement requires greater access to the spine than standard lumber fusion surgery. This also makes it a riskier procedure. Some of the potential risks of this surgery include:
- · Infection of the artificial disk or the area around it
- · Dislocation or dislodging of the artificial disc
- · Implant failure or fracture (break)
- · Implant loosening or wear
- · Narrowing of the spine (stenosis) because of the breakdown of spinal bones
- · Problems due to a poorly positioned implant
- · Stiffness or rigidity of the spine
- · Blood clots in the legs due to decreased activity
Generally artificial disk replacement surgeries take from 2 to 3 hours.
An incision will be made in the abdomen to approach the lower back. With this approach, the organs and blood vessels must be moved to the side. This allows access to the spine without moving the nerves.
The damaged disc will then be removed and the new artificial disc implant will be inserted into the disc space. The organs and blood vessels are put back in place and the incision will be closed.
In most cases, the patient will stay in the hospital for 3 to 4 days following artificial disc replacement. The length of hospital stay will depends upon how well-controlled the pain is and return to function.
Patients are encouraged to stand and walk by the first day after surgery. Because bone healing is not required following artificial disc replacement, the typical patient is encouraged to move through the mid-section. Early motion in the trunk area may lead to quicker rehabilitation and recovery.
Patient is allowed to perform basic exercises, including routine walking and stretching, during the first several weeks after surgery. During this time, it is important to avoid any activities that cause hyperextension of the back.
Cost of surgery
The cost for lumbar artificial disc replacement is approx. USD 7500 with 4-5 days hospital stay. There are certain factors that determines the cost of treatment which include:
- Overall health of the patient
- Diagnosis, type of surgery, extent of the surgery, medications used
- Technology or approach used
- Expertise of the specialist
- Accreditation, brand value of the hospital