Spinal Disc Replacement: supporting pain-free mobility through Spinal Prosthesis


Key Facts Spinal Disc Replacement (Artificial Spinal Disc)

  • • Indications: Spinal Disc Degeneration with chronic cervical pain
  • • Strategy: Spinal Disc Replacement (ADR stands for anterior disc replacement) replaces the intervertebral Disc with a disc prosthesis maintaining natural mobility of the spine
  • • Inpatient treatment: 2 days for cervical disc replacement
  • • Outpatient Rehabilitation: 5 days for cervical artificial disc
  • • Earliest flight home: 7 days after surgery for cervical disc replacement
  • • Recommended flight home: 10 days after surgery for cervical disc replacement
  • • Recommended time off work: 3 weeks for cervical disc replacement
  • • Suture removal: Cervical disc surgery - no sutures
  • • Time before driving a car: Cervical disc replacement - 1 week

Advantages of disc prosthesis over spinal fusion

  • • Maintain mobility of the spine
  • • Faster healing and recovery following surgery
  • • Better long term biomechanical results for the patient (flexibility and mobility)
  • • Quicker rates of return to work and recreational sports
  • No brace or neck collar after surgery
  • • No, wear and tear in the adjacent areas of the spine

     For many decades spinal fusion was the only option for patients with this condition, however, spinal fusion creates increased wear and tear in the adjacent areas of the fused spine. Spinal fusion is effective and safe, but always compromises the dynamics and biomechanics of the human spine. This means that the long term flexibility and mobility of the patient may be compromised.

     Following more than ten years of development, artificial discs have been improved to such an extent, that they are now considered an effective and safe treatment option for spinal disc degeneration.

Who qualifies for artificial spinal disc replacement?

Checklist for Artificial Disc Replacement
  • • Diagnostic MRI shows disc degeneration
  • • Cause of pain is neurosurgically established
  • • Non surgical therapy has been without success
  • • Other causes of chronic pain have been systematically excluded
  • • Chronic pain for more than six months

     Normally patients qualifying for artificial disc replacement will have been suffering from pain for more than six months. From a diagnostic MRI scan they will show clear signs of spinal disc degeneration. The neurosurgeon will, however, be very careful to confirm that the true cause of the pain is disc degeneration.

     Many cases of spinal disc degeneration are actually pain-free. Only persistent pain caused by spinal disc degeneration backs up the decision for surgical intervention. This means that if a patient requests an artificial disc replacement, the spine specialist will need to establish a thorough and complete medical history.

     For artificial disc replacement to be successful, the true cause of the pain has to be accurately established.

     Artificial disc replacement will be considered if the pain can not be relieved by non-surgical treatment such as physiotherapy.

Contraindications for artificial disc replacement

In these cases, artificial disc replacement surgery must not be performed.

  • • Severe Osteoporosis
  • • Vertebrate Body Fracture
  • • Segmental Instability
  • • Inflammation and Infections
  • • Injuries of Spinal ligaments
  • • Severe Spinal stenosis due to other causes
  • • Tumors of the spine

Technic for ADR

     This surgery is performed with a surgical microscope, so we do microsurgery in order to have better light and vision of the operative field and take good care of all the neural tissue.

     The first step is to remove the diseased disc from between the vertebral bodies.

     Next, the end surfaces of these vertebral bodies are cleaned to make them ready for fitting the prosthesis. The vertebral bodies are also eased apart slightly to relieve the pressure on the pinched nerve and make space for the prosthesis.

     As the spine is returned to normal posture, this seats the endplates into the vertebral bones and holds the prosthesis in place.

     During surgery, the position of the prosthesis is carefully checked by the surgeon, visually and with x-rays.

Rehabilitation following Artificial Disc Replacement

     Generally, after spinal disc replacement, there are no serious limitations on activity. Usually, on the day of surgery, unaided walking is possible and encouraged. The hospital stay following a disc prosthesis operation is 24 to 48 hours.

     After the absence of complications, the patient will be discharged from hospital.

What to expect as normal after surgery

  • • Little distress on the neck scar
  • • Swollen of the scar
  • • Little discharge from the scar for the first 24 to 72 hours
  • • Sometimes transitory difficulty with swallowing
  • • Sometimes little distress on the back of the shoulders because trans-operatory position
  • • Sometimes a little throat distress that lasts usually less than 24 hours to subside (orotraqueal intubation for general anesthesia)