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Artificial Disc Replacement: Risks, Benefits, Recovery, And Alternatives for Back Pain [2023]

Lower back pain is one of the common causes of disability around the world. It affects more than 60% of people who work desk jobs or work from home in the United States. If left untreated, it can lead to permanent nerve damage, significantly influencing one’s ability to work and limit activities. It is therefore essential to identify the primary cause of pain to determine the appropriate treatment. 

The most successful medical treatment for this illness has been a surgical intervention. Artificial disc replacement surgery (also called total disc replacement, TDR) is becoming a more popular surgical option for herniated discs or lower back pain

What is Artificial Disc Replacement?

Artificial Disc Replacement Surgery or the total disc replacement represents a newer treatment option for back and neck pain associated with lumbar degenerative disc disease. It involves removing a degenerated or painful disc and replacing it with a device that is designed to mimic the function and motion of that disc. These discs allow for movement in the spine and protect the vertebra from rubbing against each other.

Total disc replacement can be performed on either the lower back (lumbar spine) or the neck (cervical spine) and is recommended after extensive non-surgical procedures have failed to provide significant pain relief. That is, patients who have tried physical therapy, medications, etc., and still feel ongoing back and neck pain.

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 What makes artificial disc replacement surgery so exciting is that once it is implanted, the spine can still retain mobility and flexibility. The disc comes in various shapes and sizes, with the majority consisting of a metal outer shell (such as titanium or cobalt-chromium) and a medical-grade plastic within.

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Approved by the Food and Drug Administration (FDA) in the United States in the early 2000s, Artificial Disc Replacement Surgery or total disc replacement was created as a substitute for spinal fusion surgery, commonly used to treat back, neck, and thoracic pain symptoms related to herniated discs or bone spurs. Currently, there are three FDA-approved artificial disc models for use in the United States: Charite (also known as DePuy Spine, Inc.), Prestige, and ProDisc, and the number is projected to expand as new models emerge.

Who is a Candidate for Disc Replacement?

Artificial disc replacement surgery is a procedure used in treating chronic, severe low back pain and cervical pain resulting from degenerative disc disease. It is, however, not appropriate for all patients with low back pain. Therefore, your surgeon will conduct a few tests to determine if you are the right candidate for disc replacement surgery. Information from these tests will assist your surgeon in determining the true nature, source, and extent of your back pain and thoracic damage.

The following tests will be carried out:

The following features, therefore, characterize ideal candidates for artificial disc replacement surgery:

  • One or two hard intervertebral discs cause lumbar spine back pain.
  • Absence of bony compression.
  • No significant facet joints.
  • A healthy body weight, that is, not highly overweight.
  • No prior major spine surgery.
  • Absence of deformity in the spine.

Artifical Disc Replacement vs Spinal Fusion

In comparison to spinal fusion, artificial disc replacement surgery has two key advantages. First, It maintains spinal motion, which minimizes the likelihood of other lumbar spine segments prematurely wearing down.

Secondly, it is more effective than fusion in reducing back, neck, and thoracic pain. It is also less taxing for patients, and they recover faster.

When is spinal disc replacement necessary?

Spinal disc replacement may be necessary for people who suffer from severe back or neck pain, loss of mobility, or nerve damage caused by a damaged or degenerated disc. Spinal disc replacement may also be an option for those who have had a previous spinal surgery that was unsuccessful.

While an artificial disc replacement surgery is used to alleviate low back and neck pain, not everyone who suffers from back pain is a good candidate for artificial disc replacement surgery. Patients with arthritis or osteoporosis or multiple levels of lumbar pathology disease are less likely to benefit than those with lumbar disc degeneration at one level. Before deciding on an artificial disc, the patient should examine the possibility of significant operational risks. Patients should explore this option by undergoing at least six months of high-quality non-operative treatment.

Ultimately, your doctor will need to do some tests to see if artificial disc replacement surgery is the correct procedure for you. Patients should also be advised that the long-term effects of artificial disc replacement surgery are unknown and that revision surgery may be necessary for the future.

Artificial Disc Replacement: How It Works

Surgery is performed using general anesthesia. This procedure takes about 2 to 3 hours to complete, depending on the number of spinal discs to be replaced. Artificial disc replacement surgery is primarily considered for patients with a single disc problem in the lower back.

To begin the surgery, the surgeon will enter the abdomen through an incision. During the surgery, a breathing tube is placed, and the patient breathes with the assistance of a ventilator. Surgical devices are used to remove the damaged disc, and a new artificial disc is placed into the disc space.  The replaced artificial disc is typically made from plastic and metal. The surgeon will therefore proceed to close the incision after the organs and blood vessels have been replaced, and the patient will proceed to recovery. After surgery, the patient may need to stay in the hospital for about three to four days for post-operative care. 

Here is  a video providing detailed information on what an artificial disc replacement surgery looks like:

Artificial Disc Replacement Surgery: Recovery Time

Because this surgery does not require your bone to heal, the recovery time may be shorter and faster, unlike other back surgeries. Recovery can take up to 3 months. It can also vary from a few weeks to a few months, depending on the patient.

Generally, the length of time it takes to recover after an artificial disc replacement surgery entirely depends on your lifestyle and overall health. Your doctor may recommend an extended period of rest and rehabilitation if you work in a physically demanding profession or have other health concerns that slow down the healing process. You should expect stiffness and soreness in your back after the operation. You are also required to stay in the hospital for a few days so your surgeon can keep track of your recovery.

After the surgery, you will be given instructions on how and when you can resume regular activity. You may also be prescribed medications to control pain symptoms and infection reduction. Physical therapy may be required in some circumstances to restore mobility and return you to your routine.

Artificial Disc Replacement Surgery: Success Rate

According to studies, artificial disc replacement surgery has a 70-year average lifespan. This minimally invasive procedure has a better success rate because no follow-up surgery is required. Another study shows that Artificial disc replacement surgery had an 87.5 percent success rate. According to the FDA, however, this surgery has a success rate of more than 90%.

Unlike spinal fusion surgery, which has a success rate of 70 to 90%, artificial disc replacement surgery for the cervical or lumbar spine has over 90%, making it a more effective and reliable procedure. The recovery period for spinal fusion is six to eight months since it entails removing a damaged disc and inserting bone graft material. Artificial disc replacement surgery, on the other hand, does not require inserting a bone graft material, leading to a reduced rehabilitation period and quick recovery.

Another study by the FDA’s clinical trial data showed that people who underwent disc replacement surgery had a success rate of over 87% compared with 81% of spinal fusion patients.

Artificial Disc: Types

The material that an artificial disc is made of is a vital consideration for a successful operation. It must be made of safe materials to implant in the human body. They should not cause allergic reactions and should not harm other portions of the spine. Furthermore, the artificial disc should be built of material easily visible on an x-ray or other imaging test, making it easy for the surgeon to track the artificial disc’s effectiveness over time.

The Artificial discs prosthesis come in various shapes and sizes. However, there are four current design types: Composite, elastic, hydraulic, and mechanical discs.

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1. Composite Disc: 

An artificial composite disc comprises many elements, commonly two metal endplates sandwiched between them by a polyethylene (plastic) spacer. It also has a visible x-ray ring around it. The most commonly implanted composite disc to date is the CHARITÉ Artificial Disc (Link SB Charité disc, DePuy Spine, Inc.) The composite Disc (CHARITÉ Artificial Disc) has been approved by the Food and Drug Administration (FDA) for relieving back and neck pain associated with disc degeneration. 

However, this device has only been approved for single-level degenerative disc disease between L4 and L5 or between L5 and S1, in cases where there is no crucial success from back pain following six months of non-surgical treatment.

Another type of artificial composite Disc is the Bryan Cervical Disc System. Medtronic released the Bryan Cervical Disc, a polymer with metal endplates. It comprises two anatomically formed metal plates, resulting in a low-friction, wear-resistant, and elastic nucleus. A lubricant is contained within a flexible membrane, which creates a sealed compartment and reduces friction. 

This implant is available in five sizes and allows for a normal range of motion. The Bryan Total Cervical Disc Prosthesis has had a positive start in clinical trials. 

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After the release of the Bryan cervical discs, others followed. The ProDisc came out, and then there was a little bit of a hiatus before the PCM, the Secure-C, and now the Mobi-C was developed. The newest cervical artificial disc to be FDA-approved is a metal/ceramic composite called the Prestige LP. 

2. Elastic Disc: 

Like an artificial composite disc, an artificial elastic disc comprises two materials; however, instead of a plastic core, an artificial elastic disc has a polycarbonate urethane core sandwiched between two metal plates. The center core is “deformable,” emulating the natural disc’s viscoelastic qualities. 

Artificial discs of the elastic type are constructed of a rubber core attached to two titanium endplates. A study showed that the test of the elastic discs in a patient with a poor result developed a tear in the rubber. Since then, a second-generation elastic disc made of silicone rather than rubber has been approved for more testing.

3. Hydraulic Disc: 

Here, a dehydrated core is implanted in a compressed state in an artificial hydraulic disc. This artificial disc type has a gel-like core covered with a tightly woven polyethylene jacket. It is also soaked in saline, which gives space and mobility between spinal bones. The artificial hydraulic disc has been thoroughly tested, with positive results. More clinical trials are underway in Europe, South Africa, and the United States.

4. Mechanical Disc: 

An artificial mechanical disc is usually made of two articulating components of the same material (for example, metal) or a metal-ceramic composite. Studies show that patients who received this implant reported exceptional results.

Pros & Cons of Artifical Disc Replacement

As with any medical procedure, there are pros and cons to consider before deciding if artificial disc replacement is the right option for you.

Benefits of Artificial Disc Replacement

The long-term advantage of Artificial disc replacement surgery is its possibility to keep motion in the disc area while reducing strain on the spinal cord and nerve roots. Other main benefits of artificial disc replacement or total disc replacement surgery include:

  • To remove the damaged disc.
  • To restore average disc height.
  • To reduce discogenic back pain, as well as neck and thoracic pain.
  • To preserve motion in the affected vertebral area.
  • To improve body function. Improved motion and flexibility.

In comparison to spinal fusion surgery, artificial disc replacement surgery may provide faster healing, more spine movement after surgery, less stress on adjacent discs, and the elimination of the need to harvest and use a bone graft.

Risks of Artificial Disc Replacement

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 Despite its many advantages, artificial disc replacement surgery can as well pose some health risks. A significant complication is that artificial disc replacement surgery or total disc surgery requires greater access to the spine than traditional lumbar fusion surgery. 

Other potential risks that are likely to rise include:

  • It may require additional surgery to remove or replace the implant.
  • Infection of the disc may occur in days following the placement.
  • Bleeding and Infections are common risks taken with any surgical procedure.
  • Incision problems are likely to arise, including infection.
  • Implant loosening or experiencing weakening wear over time could lead to additional procedures.
  • Side effects from anesthesia.
  • Nerve damage. 
  • Bowel injuries have occurred and require bowel surgery. Scar tissue from these invasive treatments can also cause blockages of the bow
  • Many artificial disc surgeries have been proven to cause the fusion of spinal bones because of the severe trauma to the spine from the implantation of the artificial disc.

Other specific problems and complications that may arise from this procedure include:

  • Allergic reactions. For example, patients with a metal allergy.
  •  Implant failure and wear.
  •  Spinal stenosis from an infected disc.
  •  Poorly positioned implant.
  •  Surgery does not alleviate pain or symptoms.
  •  The patient’s artificial disc is the wrong size.
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Choosing the correct spine surgeon is the best approach to limit the risk of complications from Artificial disc replacement surgery. Complication rates are often lower in spine doctors with substantial experience in Artificial Disc Replacement Surgery. Spine surgeons with more experience are better at determining the appropriate artificial disc size and angulation based on the patient’s anatomy.

Alternatives to Artificial Disc Replacement Surgery

The best alternative to Artificial Disc Replacement Surgery is the Deuk Laser Disc Repair Surgery.

How it works: Deuk Laser Disc Repair is a laser spine surgery performed to cure pain or neck pain associated with herniated discs, bulging discs, sciatica, spinal stenosis, pinched nerves, and other conditions that cause chronic pain. It specializes in spine disc repair and also addresses spine concerns such as Laminectomy and microdiscectomy.  This revolutionary laser spine surgery approach uses a precision laser and unique techniques to vaporize the herniated tissue and provide the best laser spine surgery available.

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Unlike traditional spinal fusions and other laser spine surgeries, bone and surrounding tissues are not damaged during this procedure. This procedure is very gentle and minimally invasive, and it gets you back on your feet immediately.

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Recovery time: Deuk Laser Disc Repair has one of the fastest recovery times of any back surgery. Patients will typically be up and walking within the hour and can leave the hospital the same day. It is recommended that patients use hot or cold packs if they experience pain during recovery. Patients should also avoid lifting anything over 20 pounds until cleared by their surgeon. If any redness, swelling, or pain occurs after the surgery, patients should not hesitate and are directed to contact the facility. 

Deuk Laser Spine Surgery has had zero complications and a 0% infection rate. All 1,300 Deuk Laser Disc Repair surgeries done to date have been outpatient with a 1-hour recovery. 

Below is a detailed video outlining the entire process: 

Best Disc Replacement Surgeons 

If you are considering artificial disc replacement surgery, finding the right surgeon is essential for achieving a successful outcome. An experienced and skilled surgeon can help you navigate the procedure with ease and provide the best possible care. Here are some of the best disc replacement surgeons known for their expertise and high success rates

Dr. Ara Deukmedjian

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Dr. Deukmedjian is a board-certified neuro-spine surgeon who has performed thousands of minimally invasive, laser, and endoscopic back and neck pain procedures, including the revolutionary Deuk Laser Disc Repair and the Deuk Spinal Fusion. He has performed over 2,000 cervical decompressive discectomies and over 1,000 herniated or degenerated lumbar disc procedures with no severe problems, as well as hundreds of laser spine surgeries with a 95% success rate in pain relief. 

Dr. Deukmedjian is also the CEO and Medical Director of Deuk Spine Institute, where he also performs the groundbreaking Deuk Laser Disc Repair technique. Deuk Spine has had zero complications in the twelve years that Dr. Deukmedjian performed laser spinal surgery.  Dr. Deukmedjian is so confident in Deuk Laser Disc Repair that he is the first surgeon to offer a surgical warranty.

With exceptional results from Patients, Dr. Deukmedjian has been rated highly on review sites such as Vitals.com. Laser spine surgery reviews also list Dr. Deuk as the best back surgeon.

Get your free MRI assessment today.

The Bottom Line on Artificial Disc Replacement

Deuk Spine Institute is a top provider of laser spine surgery globally, with an advanced treatment option known as “Deuk Laser Disc Repair.” This procedure offers numerous advantages over traditional, invasive spine surgeries, including: 

  • Zero implants required
  • Least invasive spinal surgery globally
  • 95% success rate
  • Zero infection rate in over 1,400 procedures
  • No hospital stay
  • No internal damage or scarring
  • No need for postoperative pain medication
  • Outpatient same-day surgery, and 
  • Zero surgical complications to date.

If you are experiencing chronic back pain, neck pains, and herniated disc problems, send us your MRI scan for a free review. Deuk Spine Institute offers you a free MRI review so that you can get a second opinion on your diagnosis and treatment options. This service can help you avoid being misdiagnosed, settle for ineffective pain relief, and make informed decisions about surgery. 

By getting a free review, you can better understand your condition and explore non-invasive treatment options that may be more effective than surgery.

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Cure your back and neck pain once and for all.

Deuk Laser Disc Repair has patients back on their feet within an hour, feeling zero pain
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About Deuk Spine Institute
World leader in Laser Spine Surgery
With world-class physicians on staff, the newest and most advanced technology, and a patient experience pathway that is unrivaled in it’s efficiency and and pedagogy of care, Deuk Spine Institute has performed thousands of procedures and achieves a 95% success rate in elimination of pain.

 The services we offer are not offered anywhere else in the world, and the treatments are curative, not palliative.  On top of that, Dr. Deukmedjian is personally invested in the well-being of each and every patient, and has spared no expense to guarantee the best possible outcomes.
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