What is disc replacement?

Disc replacement removes a damaged spinal disc and replaces it with an artificial disc. Spinal discs are made of cartilage-like material. They act as cushions between two vertebrae. Your surgeon may recommend this surgery if you have back pain due to one or two damaged spinal discs. Disc replacement can improve your back pain and disability. However, it is important to have realistic expectations for disc replacement. Some pain and disability will likely remain.

Spinal discs allow your spine to move and twist. The gold standard for treating spinal pain with surgery is spinal fusion. Spinal fusion removes the spinal disc and fuses two vertebrae together. This can eliminate pain, but it also eliminates spine movement and flexibility. Disc replacement is an alternative to spinal fusion that maintains spine flexibility.

Disc replacement is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment options before having a disc replacement. 

Why is disc replacement performed? 

Your doctor may recommend disc replacement to treat spinal pain that has not responded to other treatments for six months or longer. Disc replacement is not a common surgery and is not the first choice to treat spinal problems. Ask your doctor about all of your treatment options and consider getting a second opinion.

Your doctor may recommend disc replacement if you meet the following criteria: 

  • Back pain is related to only one to two spinal discs.
  • Back pain is not related to facet joint problems or nerve compression. 
  • Spine is skeletally mature and no longer growing.
  • You are not excessively overweight.
  • You do not have scoliosis or any other spinal deformity.
  • You have not had previous spine surgery.

Who performs disc replacement?

Orthopedic surgeons perform disc replacement. Orthopedic surgeons are specially trained to treat problems of the bones and joints. They perform surgery and prescribe other treatments. 

A vascular surgeon may assist in the surgery. Vascular surgeons treat problems with blood vessels outside the heart and brain. 

How is disc replacement performed?

Your disc replacement will be performed in a hospital. It is major surgery that involves an incision in the abdomen. A vascular surgeon will move abdominal organs and vessels out of the way. This will allow access to your spine. Your orthopedic surgeon then removes the damaged disc and replaces it with an artificial disc made of metal or metal and plastic.

Type of anesthesia 

Your surgeon will use general anesthesia for your disc replacement surgery. General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the surgery and do not feel any pain. 

What to expect the day of your disc replacement

The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.
  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. The surgical team will give you blankets for modesty and warmth.
  • Talk with the anesthesiologist or nurse anesthetist about your medical history and the anesthesia you will have.
  • A surgical team member will start an IV.
  • The anesthesiologist or nurse anesthetist will start your anesthesia.
  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgical procedure as they happen.
  • The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and your vital signs are stable.

What are the risks and potential complications of disc replacement?