Lumbar Disc Replacement Surgery
Lumbar disc replacement surgery is a spine surgery for the lower back that replaces a herniated or degenerative lumbar disc with an artificial one. It is often performed to correct debilitating lower back pain and/or leg pain caused by degenerated lumbar discs. While healthy lumbar discs cushion the vertebrae of the lower spine, degenerated discs cause the bones to rub against each other, generating pain, weakness, burning, and even numbness that can extend beyond the lower back into the buttocks and legs. Lumbar disc replacement surgery can provide relief and improve your quality of life.
Why Lumbar Disc Replacement Surgery?
- Eliminates pain, burning, numbness, and weakness caused by lumbar disc herniation or degeneration
- Replaces a degenerative disc with a fully mobile artificial disc, allowing the lower spine to function in an anatomic position.
- Enables natural motion and saves the adjacent lumbar discs from additional stress that may accelerate degeneration
- Innovative approach provides a viable surgical alternative to traditional fusion surgery
- Stabilizes the spinal segment and minimizes inflammation
Individuals with a degenerative or herniated lumbar disc may need lumbar disc replacement to correct the following symptoms:
- Pain, potentially significant and often radiating from the lower back down the buttocks through one or both legs
- Burning sensation in the legs
- Numbness or weakness in the legs
- Symptoms may be isolated in the buttocks and low back, or extend down one or both legs
Candidates for lumbar disc replacement typically meet the following criteria:
- Full skeletal maturity (most patients are between ages 20 and 70)
- Confirmed degeneration of one, and up to two, lumbar discs
- Symptoms such as pain, tingling, numbness, and weakness in the lower back, buttocks, and/or one or both legs
- Nonsurgical treatments have failed to relieve symptoms long-term
- The surgery is typically performed under general anesthesia with you lying on your back.
- Many patients can go home the same day or on the day following surgery.
- The actual procedure lasts around an hour to an hour and a half
- After sterilizing the treatment area, an incision (usually 1 to 2 inches) is placed in the skin line on your abdomen underly the navel.
- A safe and small surgical window is mobilized to allow for visualization. This is known as the retroperitoneal approach and avoids surgical complications.
- The damaged lumbar disc is removed, along with any disc fragments or bone spurs.
- The disc space is restored to its normal height to eliminate nerve compression and allow for normal motion
- Using live fluoroscopy (x-ray imaging) for guidance, the artificial disc is securely placed in the disc space and fit to each patients specific size.
- The incision is then closed and sutures are placed under the skin.
- Recovery in the hospital will be carefully monitored before you are discharged home.
Lumbar disc replacement may offer advantages over traditional spinal fusion surgery, including:
- Preserves range of motion
- Reduces instability and tension caused by the painful micro-motions due to the degenerated disc
- Protects against accelerated degeneration of adjacent discs (fusion causes greater stress on the remaining vertebrae)
- Does not require any bone grafting
- Shorter recovery and quicker return to function, work, and hobbies or sports.
Frequently Asked Questions
Lumbar disc replacement may be recommended if you have a damaged or degenerated lumbar disc. Lumbar discs function as cushions or shock absorbers between the bones of the lower spine, and they can become herniated or gradually degenerate over time. Lumbar discs can also be injured or slip out of place, causing nerve pressure and pain.
Lumbar disc replacement may be recommended if your pain is caused mostly by 1 or 2 discs in your lower spine. If your symptoms inhibit your ability to function on a day-to-day basis and have failed to improve with nonsurgical treatments like physical therapy, medications, bracing, spinal injections, and/or lifestyle modifications, Lumbar disc replacement may be recommended.
For individuals who are excessively overweight, have previously undergone spinal surgery, or have significant joint disease, scoliosis, or another spinal deformity, a lumbar disc replacement is likely not the right option for your pain. There are several other options that we will discuss together in clinic.
The potential risks and benefits will be discussed with you prior to your procedure. A lumbar disc replacement surgery has many criteria that need to be met before surgery is scheduled. This procedure has one of the most strict indications and therefore can often times have a lower risk profile.
Data shows that lumbar disc replacement is a safe and viable option for patient’s lumbar spine and may hold several advantages over traditional spinal fusion surgery. With spinal fusion surgery, the damaged disc is removed and the bones are fused together. While this relieves the associated symptoms, it limits range of motion and puts additional stress on the adjacent discs that may lead to accelerated degeneration of those discs. With lumbar disc replacement surgery, the damaged disc is removed and replaced with a functional artificial disc. This typically relieves much of the associated pain, enables natural range of motion, and saves the adjacent discs from the additional stress that fusion surgery causes.
After the surgery, you will be taken to a recovery area before being situated in your hospital room. Postoperative pain is normal and can be treated with pain medications. You can resume eating your normal diet as soon as you have recovered from the anesthesia. Patients are encouraged to walk and move around on the day of surgery with therapy. You will be given physical therapy to help with rehabilitation and recovery. Most patients are discharged home on the day of surgery or on the day following. In some cases, a back brace may need to be worn for up to 4 weeks following surgery.
The key to lumbar disc replacement surgery is having appropriate surgical indications. Dr Pehler closely and carefully screens any patient considering a lumbar disc replacement prior to scheduling.