Pros and Cons of Artificial Disc Replacement

If your lower back pain hasn’t responded to nonsurgical treatments, you may benefit from motion preservation surgery. Instead of fusing vertebrae together to prevent painful motion, we replace a diseased disc with an artificial one. 

Jocelyn R. Idema, DO, is one of the few spine experts in the nation who performs artificial disc replacement for diseased discs and other causes of chronic back pain. She performs the minimally invasive surgery at our Steel City Spine and Orthopedic Center.

Is artificial disc replacement right for you? Here are some of the advantages and disadvantages of this type of back surgery.

Pro: Preserves motion

The greatest benefit of artificial disc replacement surgery is that it allows your spine to bend, twist, and flex normally. Unlike spinal fusion, which limits the movement of your spine by fusing two vertebrae together, disc replacement only affects the one vertebral set that houses the diseased disk.

Dr. Idema usually performs total disc replacement, in which she removes both the diseased disc (the nucleus) as well as its outer shell (the annulus). The artificial disc features a mechanical device that mimics the spine’s natural ability to rotate and bend. The device allows you to move your spine just as you did before you developed disc disease.

In rare cases, Dr. Idema may recommend replacing only the nucleus and leaving the annulus in place. She then removes small pieces of the diseased disc to release pressure from nearby nerves. She creates small incisions in the surrounding vertebrae to hold the artificial disc in place. 

Pro: Protects other discs

Spinal fusion surgery immobilizes two or more adjacent vertebrae to alleviate pain. But when a vertebra doesn’t move normally, the disc begins to degenerate. Spinal fusion, therefore, puts the top disc at risk, too. In fact, within 10 years about 25% of patients develop significant new disc disease.

But disc replacement allows for continued normal movement of the lumbar spine. This movement significantly reduces the need for additional surgeries and protects adjacent discs from degeneration. 

Pro: Has a shorter recovery time

Disc replacement is usually an outpatient procedure, so you don’t have to spend time in a hospital. You can return to work and normal activities in about half the time it would take to recover from spinal fusion. You also likely do not need to wear a brace after surgery.

Pro: Treats more than slipped discs

You may benefit from artificial disc replacement if you have lower back pain due to nerve compression. Conditions that respond well to artificial disc replacement include:

• Degenerative disc disease
• Herniated disc
• Facet joint osteoarthritis
• Lumbar spinal stenosis
• Spine injury

The disc replacement devices are FDA-approved. They reduce pain by alleviating pressure on nearby nerves and by reducing instability and muscle tension that’s caused by painful micro-movements when your spine tries to compensate for a diseased disc.

Con: Not everyone can have disc replacement

Unfortunately, not everyone who’s a candidate for lumbar fusion is also a candidate for artificial disc replacement. To reap the greatest benefits, you should:

• Be younger than 50 years old
• Have isolated, one-level of disc disease
• Have relatively normal anatomy above the diseased disc

When you’re over 50, you’re more likely to have arthritis in the joints of your spine, which will continue to give you pain even if the diseased disc is replaced. Also, most women and men over 50 have more than one damaged disc. In such cases, spinal fusion is the better choice.

Artificial disc replacement may not be appropriate if you:

• Have scoliosis
• Are morbidly obese
• Had previous spinal surgery

If you’re not a candidate for motion preservation, you could still get pain relief through spinal fusion or other therapies.

Con: Discs may need replacement after decades

Artificial discs are long-lasting. But if you have a disc replacement when you’re young, you could need surgery to replace the disc in the future. Discs tend to last at least 40 years. 

If you’re in pain from a degenerated disc or other issues in your lumbar spine, find out if you’re a candidate for motion preservation with artificial disc replacement surgery. Contact us today by phone or online request form to book an appointment at our Pittsburgh, McKees Rocks, or Washington, Pennsylvania, office.