6 Things to Know Before Disc Replacement

Getting an Artificial Disc Replacement (ADR) is a major decision. When done correctly and for the appropriate reasons, it can significantly improve your life. However, selecting to acquire ADR requires serious consideration and planning.

Here is everything you should know, do, or ask before undergoing artificial disc replacement surgery.

1. Why Is Artificial Disc Replacement Needed?

Many cases of neck and back pain may resolve on their own or with conservative therapies; thus, ADR is unnecessary. To be a candidate for Artificial Disc Replacement, you must have had lower back or neck pain for at least six months. Furthermore, conservative treatments such as rest, heat, pain pills, physical therapy, and injections have not completely alleviated the pain throughout that time. Lumbar artificial disc replacement treats the lower back, whereas cervical disc replacement relieves the neck.

ADR is solely intended to treat specific types of back and neck disorders. You should ensure that a CT or an MRI reveals degenerative disc disease. Simply put, is a damaged intervertebral disc the most likely cause of your pain or disability? If so, ADR could be a possibility. Finally, ensure that nothing would make ADR an unsuitable choice, i.e., a contraindication. ADR contraindications include poor bone quality, ankylosing spondylitis, rheumatoid arthritis, and severe facet joint degeneration, to name a few. Ask your spine surgeon if you require Artificial Disc Replacement and if there are any contraindications to the operation.

2. How Long ADR Lasts: Truth on ADR Results

It can be difficult to get a straight response to the question, "How long does an artificial disc replacement last?" Depending on where you acquire your information, numerous sites quote drastically different times. Modern artificial discs last for an extremely long time. Engineering experiments have shown that artificial discs can persist for more than 50 years. To be sure, tell your doctor about your level of exercise and ask your spine surgeon how long your specific artificial disc will last. This information can help you decide whether ADR is a good fit for you.

3. Know Your Alternatives

Once you've decided that spine surgery is correct for you, you need to figure out which cervical spine surgery is best for you. Fortunately, there are just two options: artificial disc replacement and spinal fusion.

ADR involves removing the diseased disc and replacing it with an artificial disc. Spinal fusion involves removing the damaged disc and fusing the spinal bones to form a bigger bone. As you might expect, ADR gives the spine more mobility and flexibility than spinal fusion, a significant benefit for most active people. Spinal fusion, on the other hand, can be performed in circumstances where ADR is ineffective, such as in persons with osteoporosis or ankylosing spondylitis.

4. Your Surgeon’s Qualifications

Artificial disc replacement is a complex process requiring expert hands and vast knowledge. While all spine doctors can conduct spinal fusion surgery, not all specialize in disc replacement. As a result, it is best to seek out someone with substantial experience in ADR and ACDF who can assist you in deciding whether to have ADR, ACDF, or no surgery at all.

Questions to Ask Your Doctor Before or During a Consultation

- Are you a neurosurgeon or an orthopedic surgeon? More importantly, are you a dedicated spine surgeon?

- Are you certified by either the American Board of Orthopedic Surgery or the American Board of Neurological Surgery?

- Do you specialize in artificial disc replacement?

- How many disc replacements have you done? (Having 50 or more ADRs is ideal.)

- What is your complication rate, and how does it compare with published reports?

5. Ask what type of anesthesia will be administered

Will your procedure be conducted using general anesthesia? Most artificial disc replacements are performed under general anesthesia unless there is a significant risk to the patient's health. Patients who cannot tolerate general anesthesia may not be suitable candidates for ADR; see your surgeon. While you're at it, ask your surgeon about post-operative pain management. Will opioids be prescribed? If so, when can they be discontinued, and non-opioid pain drugs begin?

6. Recovery Timeline

Make sure you're prepared to recover from disc replacement, which can take weeks or months. You will most likely be monitored in the surgical facility or hospital for 6 to 23 hours following surgery. Also, if you are a heavy laborer, you will most certainly be unable to work for at least two weeks following surgery; however, persons with desk occupations may be able to return to work sooner than those who must stand or lift as part of their employment. Remember to question your spine surgeon about the differences in recovery between ADR and ACDF.