The human spine is a complex structure which is made up of specialized bones called as the vertebrae. Each vertebra is stacked over one another and is separated by an intervertebral/spinal disc which plays a role of a cushion between the two vertebrae helping in smooth and easy movement of the spine. With the advancing age and degenerative diseases of the joint this spinal disc may be prone to damage, causing pain and discomfort in doing regular activities. Disc replacement is a surgical procedure where the existing spinal disc is replaced by an artificial disc made up of either metal or plastic to relieve the symptoms and aid in normal functioning of the spine.
To understand the surgical procedure of a disc replacement and its indications it is essential to understand the basic structure of the spine.
The spine of our body acts as a support system for the back and is essential for doing routine activities like sitting, standing, lying down, bending, twisting and turning. A normal spine performs these and other functions without causing any pain and soreness. The spine is made of 33 vertebral bones which are stacked over one another with and intervertebral disc between them and are divided according to their location as the cervical, thoracic, lumbar, sacral and coccygeal vertebrae.
The main function of cervical vertebrae is to bear the weight of the skull and brain and support the neck region. The thoracic vertebrae form the major bulk of the upper back and protect the heart and the lungs whereas the lumbar vertebrae support the lower back region. The sacral vertebrae connect the spine to the hip bone and the coccygeal vertebra is a vestigial remnant of the tail bone.
The vertebrae are complex structures and act as a support system to hold the spine and the spinal cord which runs through them. Two vertebrae are separated by an intervertebral disc which is made up of a cushion like material to provide springiness and flexibility during movement of the spine.
The intervertebral disc or the spinal disc acts as a shock absorber and a protective covering around the spinal cord. The spinal disc is made up of two compartments, annulus fibrosus or the outer compartment which protects or outlines the inner compartment known as the nucleus pulposus. These compartments protect, outline and cover the spinal cord.
When is a disc replacement surgery advised ?
Spinal disc acts as a shock absorber between the vertebrae and any damage to the same can result in potential symptoms of pain and discomfort restricting one from doing routine activities with ease. The most common symptom encountered is back pain. The back pain can be a result of a degenerative disc disease like arthritis, advancing age, overweight increasing the wear and tear of the spinal disc or any long standing injury to the spinal disc. A disc replacement surgery is indicated as an option when the pain associated with shoulders, back and leg is continuous and is not relieved by pain medication and physical therapy for over six months or more. The decision to get a disc replacement procedure done is a combined result of thorough clinical examination of the spine and its components guided by radiographs and CT/ MRI scans to identify the location of the damage in the spine. Besides the indications there are conditions where a disc replacement surgery is not indicated such as spondylolisthesis, vertebral body fracture, osteoporosis, obesity, history of previous spine surgery and autoimmune disorders. Disc replacement surgeries can be further classified as follows.
On the basis of the type of procedure.
- Total Disc Replacement (the entire disc is replaced by artificial implant)
- Partial Disc replacement ( the central portion of the disc is replaced by an artificial implant)
On the basis of location of the surgery.
- Cervical Disc Replacement (at the level of cervical vertebra)
- Lumbar Disc replacement (at the level of lumbar vertebra)
What does disc replacement surgery involve ?
The disc replacement procedure is usually performed under general anesthesia. When the lumbar disc to be replaced it is surgically approached from the abdominal area. The incision is made close to the belly button area followed by which the abdominal muscles and intestines are retraced to expose the spine and the corresponding spinal disc to be replaced. Help of X-ray imaging is taken to confirm the location of the disc to be replaced and placement of the artificial disc. The wound is then cleaned with sterile water containing antibiotics and appropriate care is taken to keep the wound dry. The procedure usually lasts for about 3-4 hours or may extend depending upon the number of spinal discs to be replaced.
What care should be taken after a disc replacement surgery ?
Appropriate care must be taken to prevent any infection at the site of the wound. The patient is usually put on antibiotics and pain medication after the surgical procedure. Immediate movement is restricted to avoid post operative complications and daily activities like sitting, walking, showering are done under the guidance of a physical therapist. Care must be taken not to bend downwards, twist the waist post operative to avoid any strain at the site of the wound. The operating surgeon with a physical therapist designs a customized plan to initiate movement post operatively to aid in recovery and improve functionality of the spinal disc.
Disc replacement procedures have been performed for over decades now and help in faster regaining of function as compared to the other spine surgeries. The choice of getting a disc replacement done is based on the combined decision of the operating surgeon and the patient after a thorough analysis of the risks and benefits of the surgical procedure. Lumbar disc replacements are more commonly done than the cervical disc replacement procedures. Literature suggests that the outcome of disc replacements is a success in treating long standing back pain and restoration of the functional activities which were affected by the damaged or diseased spinal disc.
If it all you have been recommended a disc replacement surgery then always take a second opinion. Remember that a major surgery like disc replacement surgery is always a last option when no other conservative treatment options are available. Moreover a disc replacement surgery may not be suitable in all the cases. Hence whenever in doubt, please consult an experienced spine specialist.
How to find and reach spine surgeons for spine disc replacement surgery ?
Now you can find and reach spine surgeons for disc replacement surgery from different hospitals and destinations on a single platform, Hinfoways. You can avail opinions and information from multiple spine surgeons, get cost estimates for disc replacement surgery from different hospitals, compare things and then choose a spine surgeon for disc replacement surgery.
Find, reach and choose a spine surgeon for disc replacement surgery on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
