Lumbar Disc Replacement

Lumbar disc replacement aims to preserve spinal motion and function by replacing a diseased or damaged lumbar disc with an artificial one. Lumbar disc replacement is preferable, in most cases, to lumbar fusion. Lumbar fusion is a procedure that fuses two or more spinal bones (vertebrae) together. Both spine surgery procedures can relieve pain and other symptoms; however, we will explore why lumbar disc replacement is a superior choice for those who are candidates for the procedure.

What is Lumbar Disc Replacement Surgery?

Lumbar disc replacement surgery is a procedure that involves removing a damaged or degenerated disc in the lower spine and replacing it with an artificial disc. The purpose of this surgery is to relieve pain, restore function, and maintain the natural movement of the spine. Lumbar disc replacement is an alternative to spinal fusion surgery, which permanently joins two vertebrae together. Unlike fusion, lumbar disc replacement aims to preserve spinal motion and function by replacing the damaged disc with an artificial one that can mimic the movement of a natural, healthy disc.

Some of the key advantages and potential benefits of lumbar disc replacement include:

Relieving chronic low back pain by removing the damaged disc and restoring the normal height between the spinal bones
Preserving the spine's ability to bend, flex, and rotate, unlike fusion which limits spinal range of motion
Reducing the risk of adjacent segment degeneration, which can occur with spinal fusion
Allowing patients to return to many of the activities they once enjoyed, with a lower risk of serious complications compared to fusion

Overall, lumbar disc replacement aims to provide pain relief and restore spinal function and mobility, making it a viable alternative to the more restrictive spinal fusion procedure for certain patients with degenerative disc disease in the lower back.

How do I know if I need a Lumbar Disc Replacement?

Patients who may be candidates for lumbar disc replacement often experience persistent low back pain that radiates to the hips or legs; difficulty standing, walking, or performing daily activities due to pain; and limited range of motion and flexibility in the lower back. You may be a candidate for lumbar disc replacement if you have chronic low back pain due to degenerative disc disease in the lumbar spine, have tried and failed conservative treatments, are between the ages of 18-65 and in generally good health.

Who is NOT a good candidate for LDR?

You may NOT be a candidate for lumbar disc replacement if you have bone cancer, osteoporosis, moderate or severe facet joint disease, allergy to artificial disc materials, or a severely abnormal curvature of the spine. If you have had certain forms of lumbar spine surgery, you may not be able to have lumbar disc replacement.

What are the benefits of a lumbar disc replacement?

Restores Spinal Stability and Flexibility – Lumbar disc replacement addresses the damaged disc directly, allowing patients to experience reduced pain levels, greater spinal stability, and improved flexibility compared to before the surgery.
Preserves Adjacent Discs from Accelerated Degeneration – By replacing the damaged disc rather than fusing the vertebrae, lumbar disc replacement can help prevent additional stress and degeneration on the discs above and below the affected level.
Reduces the Need for Future Surgeries – Lumbar disc replacement is a highly successful procedure, with the artificial discs often lasting for decades. This reduces the chances of needing additional spinal surgeries.
Enhances Post-Operative Mobility – Unlike spinal fusion, which limits spinal range of motion, lumbar disc replacement preserves the spine's ability to bend, flex, and rotate, allowing patients to return to many of their previous activities.

Overall, lumbar disc replacement aims to relieve chronic low back pain, restore spinal function and mobility, and reduce the risk of further degeneration and the need for additional surgeries, making it a viable alternative to the more restrictive spinal fusion procedure for certain patients.

Surgical Procedure: Lumbar Disc Replacement

The typical steps for a lumbar disc replacement surgery are as follows:

The patient is placed under general anesthesia
The surgeon makes a small incision in the abdomen to access the spine from the front (anterior approach).
The surgeon carefully moves aside the organs and blood vessels to expose the damaged disc in the lower spine.
The problematic disc is removed, including the inner nucleus and outer annulus, and any fragments that may have broken free from the main body of the disc.
The surgeon selects the appropriately sized artificial disc implant.
The artificial disc, made of metal and/or plastic components, is then inserted into the disc space.
The organs and blood vessels are returned to their normal positions, and the incision is closed.

The two main choices for lumbar artificial discs currently available in the US are the activL and the ProDisc-L. A third type, the Charite lumbar disc, is no longer used. New lumbar disc replacement implants are under investigation and may soon be available at select sites in the US with extensive experience with disc replacement surgery.

What is the Success Rate of Lumbar Disc Replacement Surgery?

The long-term effectiveness of lumbar disc replacement is quite high with success rates reported as high as 87.2%. Patient satisfaction rates (very satisfied or satisfied) range from 86% to 93.3%.

Lumbar ADR Recovery and Rehabilitation

Recovery from lumbar disc replacement varies from patient to patient; however, the recovery is substantially faster than it is after spinal fusion.

Lumbar Disc Replacement Surgery Recovery Time

You will have limits on your activity for the first two weeks after surgery, especially driving, heavy lifting, and certain forms of exercise. Walking is fine and encouraged as much as possible.

You will likely be cleared to drive and return to light work within two weeks. Physical therapy usually starts at weeks 2 through 4. Discuss your probable lumbar disc replacement surgery recovery time with Dr. Strenge at one of your preoperative appointments.

Why Choose Dr. K Brandon Strenge for Lumbar Disc Replacement Surgery in Kentucky

Dr. Strenge is a fellowship-trained orthopedic spine surgeon who specializes in minimally invasive spinal procedures and motion-preserving treatments like artificial disc replacement. He has extensive experience and expertise in this advanced technique. Dr. Strenge is also actively involved in clinical research trials for the newest artificial disc replacement technologies and surgical techniques, which ensures he is using the latest and most effective methods to care for his patients. This is why Dr. Strenge’s patients are very satisfied with the care he provides. Dr. Strenge is a regional leader in spine surgery and certainly one of the best surgeons in Paducah, KY to perform lumbar disc replacement.

FREQUENTLY ASKED QUESTIONS

What is the difference between lumbar fusion and lumbar disc replacement?

In both spine surgeries, the problematic lumbar disc is removed. However, in lumbar disc replacement, the problematic disc is replaced with an artificial lumbar disc (activL or ProDisc-L). In lumbar fusion, the two vertebrae on either side of the problematic disc space are fused together.

How long does a lumbar disc replacement last?

Artificial discs are designed to last 50 to 80 years through accelerated wear testing. While no patients have had lumbar discs inserted that long (first FDA approvals were ~20 years ago), patients have had implants last 10 years, 20 years, or even longer.

How do you qualify for a lumbar disc replacement?

You may be a candidate for lumbar disc replacement if you have had low back pain or symptoms for at least several weeks and conservative treatments have failed. Contact Dr. Strenge today to find out if you are a candidate for lumbar disc replacement.

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