If you’re considering spine surgery, it’s important to know your options.
Many patients aren’t aware that artificial disc replacement could be their best option for treating back or neck pain, according to Dr. Richard D. Guyer, M.D., a spine surgeon on the medical staff at the Center for Disc Replacement at the Texas Health Center for Diagnostics and Surgery.
Before the advent of artificial disc replacement, spinal fusion was the only option for many patients with persistent pain in the lumbar (lower back) or cervical (neck area) spine.
“If you have a friend or a family member that's been recommended a fusion surgery, it may be perfectly appropriate,” said Dr. Guyer. “But at a minimum, they owe it to themselves to get another opinion from someone who is an expert in the field of disc replacement.”
Spinal fusion is essentially a “welding process,” fusing together two or more vertebrae so that they heal into a single, solid bone, to eliminate painful motion or to restore stability to the spine.1 By contrast, lumbar artificial disc or cervical artificial disc replacement involves removing worn or damaged disc material between the small bones in the spine (vertebrae) and replacing it with a prosthetic, or artificial disc. The procedure offers the advantage of relieving back pain while maintaining more normal motion than fusion surgery.2
Many patients considering back surgery aren’t aware of artificial disc replacement as a possible option. Guyer says those patients should at least consider this option before undergoing fusion surgery. Just as hip replacement has become well-known as the gold standard for treating hip pain, he thinks disc replacement will quickly become the gold standard for many patients with back or neck pain.3
“If you had a bad hip joint and you went into the doctor and the doctor said, ‘I'm going to do a fusion,’ you would probably turn around and walk straight out the door and find another doctor who at least considers total joint replacement,” Dr. Guyer said.
Fusion surgery does remain a viable option for some patients, who for one reason or another are not eligible for artificial disc replacement. But for those who are good candidates, artificial disc replacement typically provides an easier recovery and longer-lasting results.4 That’s why a second opinion from a disc replacement surgeon is essential.
“I think all of us that are experts in this area will tell the patient, honestly, either ‘You're not a candidate,’ or, ‘Yes, you'd be a wonderful candidate,’” Dr. Guyer said.
There are two key types of disc replacement surgery: lumbar artificial disc replacement for pain in the lower back, and cervical artificial disc replacement for pain in the neck area.
“The lumbar artificial disc has been one of the biggest advancements for low back pain that we've ever had in modern medicine,” said Dr. Guyer.
“The cervical artificial disc likewise has been a tremendous advancement. Cervical fusion surgery was fairly effective, but the re-operation rate tends to be lower with disc replacement surgery because an artificial disc helps maintain normal motion.”5
Cervical disc replacement is typically recommended for patients experiencing arm pain from a herniated disc or from a bone spur. It’s also effective for patients with spinal stenosis, which may affect the arms as well as the legs.
“We also see many patients that have chronic neck pain from degenerative disc disease accompanied by chronic headaches,” said Dr. Guyer. “In many cases, the headaches and the neck pain can be successfully treated with cervical disc replacement.”
Many patients ask, “How long do artificial discs last?”
FDA regulations require that all artificial discs must undergo mechanical testing in a lab that proves they can last at least 40 years.
Surgeons at the Center for Disc Replacement, including Dr. Guyer, have been performing artificial disc replacement since 2000. They’ve been closely involved in the research and development that has advanced artificial disc replacement surgery over the past 23 years. They continue to tally data with patient follow-ups, but to date, the results look promising.
“When we first started performing lumbar artificial disc replacements, we told patients they would probably last 10 years, similar to hip replacements,” said Dr. Guyer. “But now that we have 23 years of experience with the procedure, and we’ve followed up with these patients, we’re seeing that even some of our earliest patients are continuing to have functioning artificial discs.”
If you are considering spine surgery, take a few minutes and complete our disc replacement assessment or download our disc replacement reference guide to find out if artificial disc replacement could be right for you.
[1] American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/treatment/spinal-fusion/#:~:text=Spinal%20Fusion%20Procedure-,video,into%20a%20single%2C%20solid%20bone.
[2] American Academy of Orthopaedic Surgeons
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4360606/
[4] https://pubmed.ncbi.nlm.nih.gov/23082849/ [pubmed.ncbi.nlm.nih.gov]
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6394883/