The Ultimate Guide to Choosing the Right Disc Replacement Surgery

If you experience chronic back pain that doesn’t respond to physical therapy, medication, and other non-invasive therapies, you might be a candidate for disc replacement surgery. This occurs when your surgeon removes damaged, painful discs that are supposed to protect your spine and replaces them with artificial models. These artificial discs act like the ones in your body and can restore your range of motion while reducing your pain levels.

Disc replacement surgery is often considered a permanent option for addressing back pain. The artificial discs can last for several decades and these operations have very high success rates. Every patient is different and there are multiple types of disc replacement surgery options that your doctor could recommend.

If you are a candidate for disc replacement surgery or want to talk to your doctor about this treatment option, learn about the different types available. This can make you a more informed patient as you seek help for your back pain.

Types of Disc Replacement Surgery

The human body has 23 vertebral discs that are built into the spinal column. These discs start in your neck and continue all the way down to your lower back and buttocks. This means that your source of back pain could come from one or more of these discs and occur throughout the core of your body.

Fortunately, there are multiple types of disc replacement surgery that can address your back pain. Here are a few options that your doctor will talk to you about.

Artificial Disc Replacement (ADR)

Artificial disc replacement (ADR) is also referred to as total disc replacement (TDR). Your doctor might prefer one term over another or use them interchangeably. With this procedure, your doctor fully removes the broken or damaged disc and replaces it with an artificial model. The main advantage of this operation is motion preservation. Removing the broken disc prevents it from further damage and from interfering with your nerve canal.

Candidates for ADR often have to undergo non-invasive treatments before they are approved for surgery. This is because any operation – no matter how small or invasive – comes with risks and recovery needs. Your doctor will want to see if the damaged disc responds to other options before choosing to operate. TDR is a relatively fast procedure and usually only takes an hour or two.

Hybrid Disc Replacement

If you have multiple broken spinal discs, your doctor might recommend a hybrid disc replacement (HDR). This occurs when the surgeon does both a disc replacement and spinal fusion operation at the same time. While the artificial disc can preserve the patient’s range of motion, the spinal fusion works to stabilize the spine.

HDR is often recommended for patients who need multiple discs replaced. Your doctor will do their best to use artificial models but might need to fuse one or more of your vertebrae in some places. Their decision to fuse your spine will depend on the location of the damaged discs and the extent to which fusion can impact your ability to turn, bend, twist, and move comfortably.

This option is ideal for patients who want to fully address their back pain in one operation. However, the fusion can limit your ability to move comfortably and is often a more invasive procedure.

How to Prepare for Disc Replacement Surgery

While both TDR and HDR have high success rates, your doctor should not rush into the decision to operate on your spine. Instead, they will evaluate the discs in your back and learn about your health and activity level during the pre-surgery evaluation.

You don’t have to feel nervous going into this evaluation. Your doctor wants to get to know you, including your lifestyle and any other medical conditions you have. They want to learn where you experience back pain and any other symptoms (like tingling or numbness) that come with it. At the end of the appointment, your doctor might request some additional tests to look at your back. An X-ray or MRI can provide a clearer picture of your spine to see if you need surgery.

If you are a candidate for ADR or HDR and have already tried non-invasive methods of pain management, your doctor might recommend that you move forward with the operation.

Who is a candidate for Disc Replacement Surgery?

Disc replacement surgery, whether you need TDR or HDR, can address a variety of medical conditions. Here are a few spinal problems that these operations can treat:

  • Degenerative disc disease (DDD)

  • Pinched nerves in the spine

  • Herniated discs

  • Damaged or broken discs caused by trauma (like a car accident or sports injury)

While TDR and HDR are very flexible procedures, there are times when candidates might not be approved for these operations. Contraindications – limitations that prevent approval – include pregnancy, rheumatoid arthritis, osteoporosis, and morbid obesity. In these cases, the patient might not be strong enough to make it through the operation or their bones might not be able to support the artificial disc or bars used in the fusion process.

There are additional reasons why your doctor might not approve you for ADR or HDR. They might want you to change your lifestyle so you are healthier going into surgery. This could mean quitting smoking, taking up exercise, or adopting a healthier diet. Older patients and patients with existing medical conditions also might not qualify for surgery.

This is why the pre-surgery evaluation is so important. It allows your doctor to see if you will have a high chance of success during the recovery process.

Why Chose Dr. Strenge

One leading spinal surgeon known for supporting patients is Dr. K. Brandon Strenge, who is based in Paducah, Kentucky. Dr. Strenge is a fellowship-trained orthopedic spine surgeon who specializes in minimally invasive operations and preserving the range of motion of patients. He is the principal investigator for many clinical trials with a focus on the newest artificial disc replacements. He is one of the top choices for ADR and HDR in the country.

If you live with back pain, meet with a surgeon who can address your problems with long-term solutions. Request a consultation with Dr. Strenge and take the first steps toward healing.

FREQUENTLY ASKED QUESTIONS

What is the recovery time for disc replacement surgery?

Your recovery timeline will depend on the type of disc replacement you have. However, a standard single-level ADR will take around six weeks to recover, sometimes less. More invasive operations, like HDR, will have longer recovery periods. It might take three to six months to completely heal and restore your range of motion after your operations. 

How long does disc replacement surgery last?

Disc replacement surgery is considered a permanent solution to back pain. Your artificial discs are approved to last at least 10 years, though some studies indicate they can last around 40 to 100 years. HDR has a similar timeline. Fusion can be permanent, though you might need another operation after a few decades.

What is the success rate of disc replacement surgery?

Every patient is different, which means your doctor cannot guarantee that your disc replacement will be successful. However, patient satisfaction across eight studies ranged from 75.5% to 93.3%. The overall reoperation rate – which means the initial procedure was not successful – was around 12.1%.

 

There are similar rates of success for HDR. In one study, 80% of patients said they were satisfied with the results of the procedure eight years after the operation. This speaks to the longevity of the solution to preserve their range of motion while reducing pain levels. 

Can I still participate in physical activities after disc replacement surgery?

You will not be able to engage in physical activity, stay on your feet for several hours, or lift heavy objects in the weeks following your surgery. However, as your body heals, you can return to work and resume your favorite hobbies. Your doctor will let you know when it is safe to do so. 


Once you are fully healed, you should be able to participate in various physical activities, regardless of whether you have TDR or HDR. Many athletes who undergo disc replacement return to the sport as competitive and strong as ever.

Is disc replacement surgery covered by insurance?

In most cases, disc replacement should be covered by insurance. This is considered a medically necessary operation to maintain your quality of life. If you have questions about coverage, talk to your doctor or your insurance provider.

How do I choose between disc replacement and other spinal surgeries?

In most cases, you won’t have to choose between types of operations as your doctor will make recommendations based on your specific case. However, if there are multiple options available, go over the pros and cons of each one with your surgeon. Ask about the recovery process, range of motion restoration, and long-term outcomes of each operation. This information can help you make the best choice.

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