Who is a Good Candidate for Disc Replacement Surgery?

If you are experiencing chronic pain or related symptoms due to a herniated disc, you may be a candidate for disc replacement surgery. Here’s how to tell if you are a good candidate for disc replacement and whether this procedure could be right for you.

What is a Herniated Disc?

Spinal discs are small, round cushions between the spinal vertebrae (the bones of your spine). They act as shock absorbers and help to keep your spine flexible and mobile. If a disc is degenerative or damaged (“herniated”), it can cause the bones to rub against each other. This leads to symptoms such as pain, numbness, and weakness, as well as limited range of motion. Individuals who are suffering from these symptoms may have a herniated disc, and they may benefit from disc replacement surgery.

How Do I Know If I Have a Herniated Disc?

Most herniated discs occur in the neck area (cervical spine) or lower back area (lumbar spine).

A herniated cervical disc can cause the following symptoms:

  • Pain, potentially significant and often radiating from the neck to the upper back and one or both arms
  • Burning sensation or “pins and needles” in the neck, upper arms, or back
  • Stiffness in the neck
  • Headaches
  • Numbness or weakness that travels down one or both arms
  • Neurological problems such as trouble using your hands, balancing, walking, or controlling your bladder (in more severe cases)

A herniated lumbar disc can cause 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

In addition to recognizing the symptoms, an orthopedic spine surgeon will need to confirm the degeneration of one or more spinal discs. During your consultation, your surgeon will review your medical history, perform a physical examination, and order diagnostic tests such as X-rays, MRI scans, and CT scans. These tests will reveal whether you have a herniated or degenerative disc and direct the course of your treatment.

What is Disc Replacement Surgery?

Individuals with a herniated disc may benefit from undergoing disc replacement surgery. Also called artificial disc replacement, this is a type of orthopedic spine surgery that involves removing a herniated disc and replacing it with an artificial disc. If the procedure is performed on the neck, it is called cervical disc replacement; if performed on the lower back, it is called lumbar disc replacement. The removal of the damaged disc alleviates pain and related symptoms, and the new artificial disc maintains natural motion of the spine.

Am I a Candidate for Disc Replacement Surgery?

All candidates for disc replacement surgery will meet the following criteria:

  • Confirmed degeneration of one or more spinal discs
  • Symptoms such as pain, tingling, numbness, and weakness (see above)
  • No significant underlying spinal deformity
  • For lumbar disc replacement candidates, symptoms are caused mostly by 1 or 2 adjacent discs in the lower spine
  • For cervical disc replacement candidates, there may also be neurological deficits or signs of nerve compression, such as difficulty with balance, using hands, walking, and bladder function

Candidates must also be in generally good overall health and have full skeletal maturity. In nearly all cases, candidates start with conservative treatments and should only be considered for disc replacement surgery if nonsurgical treatments have failed to relieve symptoms long-term.

Who is Not a Candidate for Disc Replacement?

You may not be a candidate for disc replacement surgery if you have any of the following conditions:

  • Spinal deformity (such as scoliosis)
  • Severe osteoporosis
  • Spinal infections
  • Spinal tumors
  • Significant joint disease
  • Multiple disc herniations
  • Previous spinal surgery
  • Being excessively overweight

For these individuals, disc replacement will likely not be the right option for you. There are several other treatment options that can be considered to relieve your symptoms.

Additionally, some individuals who qualify for this surgery may not end up needing it. Nonsurgical treatments such as physical therapy, medication, bracing, spinal injections, and/or lifestyle modifications can sometimes relieve symptoms sufficiently enough to save patients from having to undergo surgery. Your orthopedic surgeon can help you determine whether you should try conservative treatments first or whether you are a candidate for surgery at this time.

Is Disc Replacement a Better Surgery for Me than Traditional Spinal Fusion?

Disc replacement surgery is a newer procedure that has quickly become a popular alternative to traditional spinal fusion surgery. While spinal fusion has been around longer, it has one distinctive disadvantage: after removing the herniated disc, the two vertebrae are fused together, which alleviates symptoms but limits the natural movement of the spine. This reduces flexibility and places additional stress on the surrounding discs, which can lead accelerated degeneration of the adjacent discs (adjacent segment disease).

For many candidates, disc replacement is a better surgery option than traditional spinal fusion. Because disc replacement exchanges the herniated disc for an artificial one, the vertebrae can continue to move freely, and no additional stress is placed on the surrounding discs. Individuals who wish to maintain full mobility of the spine and especially those who are at higher risk of adjacent segment disease are usually better candidates for disc replacement.

What are the Benefits of Disc Replacement Surgery?

Disc replacement surgery offers several benefits that may appeal to you:

  • Alleviates symptoms of a herniated disc
  • Preserves range of motion
  • Reduces instability and tension in the spine
  • May protect against accelerated degeneration of adjacent discs
  • Does not require any bone grafting
  • Less invasive than spinal fusion
  • Faster recovery and quicker return to function, work, and hobbies or sports (as opposed to fusion surgery)

If you qualify as a candidate for artificial disc replacement, and conservative treatments have failed to give you the symptom relief you seek, talk to your orthopedic surgeon. Undergoing disc replacement surgery could resolve your symptoms and help you enjoy a better quality of life.

Call 303-695-6060 or fill out our online contact form to schedule your appointment with our board-certified, Denver-based orthopedic spine surgeon, Dr. Stephen Pehler.