Artificial lumbar disc surgery is a surgery in the low back performed to replace a disc that is damaged or worn out. Lower back pain is an extremely common disability which can affect one's quality of life. Lower back pain can lead to difficulty working or performing daily tasks. A few causes of pain in the lower back include disc herniation, instability or degenerative discs, spondylosis, as well as arthritis of the joints in the spine.
TESTING AND DIAGNOSIS
An evaluation by the doctor will be performed to determine the main cause of the lower back pain. During this evaluation, a physical examination will be performed to locate the source of pain. Before performing a surgery, the doctor will order imaging and tests. This can include x-rays, magnetic resonance imaging (MRI), and computed tomography (CT). These tests and images will allow the doctor to assess the patient's discs and bones. A provocative discogram could assist the doctor in deciding if the damaged or worn disc on the images is the causing the patients pain.
TREATMENT
Non Surgical Treatments
There are multiple options for treatment of discogenic back pain that do not include surgery. Examples of these treatments include pain medication, physical therapy, bracing, spinal injections, as well as other forms of therapy.
Surgical Treatments
Signs for Surgery
Artificial disc surgery is a surgery created to avoid the possible consequences of spinal fusion surgery. Spinal fusion surgery is a common procedure for pain in the lower back from a degenerative disc. Fusion surgery may lead to irregular healing, pseudarthrosis, and an increase in stress on the spine around the fusion. A patient can be a contender for artificial disc surgery if a single degenerative disc has caused the patient pain for more than six months and the patient has not seen results from physical therapy or other nonsurgical treatments.
Objectives of surgery
The main goals of an artificial disc surgery are to remove damaged or worn disc, reinstate normal disc height, lower discogenic back pain, protect movement and motion in the affected spinal segment, and lower pain. Getting an artificial disc surgery compared to a spinal fusion surgery may lead to a quicker recovery period, an increase in spine motion post surgery, a decrease in stress on discs above or below affected disc, and no bone graft.
Surgical Procedure
An incision will be made in the abdomen of the patient while under general anaesthesia. The incision will create an opening for the damaged disc to be taken out and replaced. After surgery, the patient will have around 3 to 4 days of hospital stay.
Potential complications of artificial disc surgery:
- Possible chance of another surgery to take out or replace the implant
- Allergic reaction caused by the materials used for the implant
- Bleeding
- The implants could move position or break
- Infection
- Sexual dysfunction in males
- Pain
- Discomfort
- Side effects of anaesthesia
- Decrease in intestinal movement
- Damage to the spinal cord or nerves
- A tearing of the dura
- Leakage of spinal fluid
OUTCOME
The medical community is currently discussing the benefits of artificial lumbar disc surgery. Many patients have experienced a decrease in back pain and improved function post artificial lumbar disc surgery. Comparing the outcome of artificial disc surgery to a spinal cord fusion has not proved a significant difference. The durability of the implants are being discussed as well. Multiple cases have been reported of disc moving out of place for unknown reasons. Implants that have movement or motion may lead to debris over time. The effects are undetermined of debris on the spine. To assess the efficacy and safety of an artificial lumbar disc surgery compared to a spinal fusion will require long term monitoring.
