Artificial Disc Replacement
(Cervical and Lumbar)
Artificial Disc Replacement (ADR) is a surgery for damaged spinal discs in the neck (cervical) or lower back (lumbar). It involves replacing the problematic disc with an artificial one to restore normal spine movement and flexibility.
Cervical and lumbar disc replacement are surgical procedures designed to treat degenerative disc disease in the spine. Let's break down each one:
Cervical Disc Replacement (CDR):
Cervical disc replacement is performed in the neck region, specifically in the cervical spine. It is often done to alleviate pain and restore motion in the cervical spine caused by degenerative disc disease, herniated discs, or other spinal conditions. During a cervical disc replacement surgery, the damaged or herniated disc in the neck is removed and replaced with an artificial disc. This artificial disc is designed to mimic the function of a natural disc, providing stability to the spine while allowing for normal range of motion.
Lumbar Disc Replacement (LDR):
Lumbar disc replacement is performed in the lower back, specifically in the lumbar spine. Similar to cervical disc replacement, it aims to address pain and dysfunction caused by degenerative disc disease or other lumbar spine conditions. In lumbar disc replacement surgery, the damaged or degenerated disc in the lower back is removed and replaced with an artificial disc. This artificial disc is designed to maintain spinal stability and flexibility, allowing the patient to move more freely and, ideally, reducing pain associated with the affected disc.
Both cervical and lumbar disc replacement surgeries aim to preserve or restore normal motion in the spine while providing stability. These procedures are considered alternatives to traditional spinal fusion surgery (which involves fusing vertebrae together). The advantage of disc replacement is that it allows for more natural movement at the treated spinal level compared to fusion, which can limit motion in that segment of the spine. This places less stress on the adjacent level in the spine and decreases the likelihood of accelerated arthritis build-up at the adjacent levels (adjacent segment disease).
It's essential to note that not all patients are suitable candidates for disc replacement, and the decision to undergo such surgery is typically made after a thorough evaluation.
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- If a patient is an appropriate disc replacement candidate, disc replacement surgery is preferred over fusion.
- Unlike a fusion, we want you to move your neck after a disc replacement. Because of this, a collar is not necessary after disc replacement surgery. Sometimes we prescribe a soft collar after surgery for comfort purposes.
- Candidates for disc replacement surgery typically have symptomatic degenerative disc disease or a herniated cervical disc and have not responded to conservative treatments such as physical therapy, chiropractic manipulation, activity modifications, NSAIDs, injections, etc.
- Disc replacement preserves motion at the treated level by replacing the damaged disc with an artificial one. In contrast, spinal fusion eliminates motion by fusing adjacent vertebrae together using bone grafts or substitutes.
- The potential benefits include reduced pain, improved mobility, and maintaining natural range of motion.
- Unlike a fusion, where recovery takes about 3 months. The recovery after a disc replacement is usually a month. This is because the goal of surgery is to maintain motion, rather than fuse the bones.
- Newer generation artificial discs are designed to withstand normal wear and tear and have undergone simulated wear to withstand at least 40 years of wear and tear. Although there is no definitive time frame for how long these discs are meant to last, there are studies with great outcomes in patients 20+ years after the initial surgery without the need for revision.
- 1 and 2 level cervical disc replacement surgery is covered by most insurances. Insurance typically will not pay for 3 level cervical disc replacement. In this instance, some patients will elect to pay out of pocket for the third level.
- Most insurance carriers will pay for a 1 level lumbar disc replacement. Despite being FDA approved for up to 2 levels in the lumbar spine, most insurance carriers will not pay for second level lumbar disc replacement. In these instances, some patients will elect to pay the difference in costs out of pocket for their lumbar disc replacement surgery.