Lumbar disc replacement is a motion-preserving spinal procedure used to treat certain cases of degenerative disc disease in the lower back. The damaged disc is removed and replaced with an artificial disc designed to maintain movement while relieving pain and restoring disc height.
Quick Facts:
- Replaces a damaged lumbar disc with an artificial implant
- Preserves motion at the treated level
- May be an alternative to spinal fusion in selected patients
- Most commonly performed at L4-5 or L5-S1
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👉 Lumbar Disc Replacement Information Packet
WHAT IS LUMBAR DISC REPLACEMENT?
Lumbar disc replacement, also called total disc arthroplasty, is a procedure that removes a painful degenerative disc and replaces it with an artificial disc.
The procedure involves:
- Accessing the spine through the front of the abdomen
- Removing the damaged disc
- Preparing the vertebral endplates
- Implanting an artificial disc
- Preserving motion at the treated spinal level
Unlike spinal fusion, disc replacement is designed to maintain movement rather than permanently eliminate motion.
👉 The goal is to relieve pain while preserving normal spinal mechanics.
WHY IS LUMBAR DISC REPLACEMENT PERFORMED?
Lumbar disc replacement may be considered for carefully selected patients with symptomatic degenerative disc disease.
Common Indications
- 1 or 2-level degenerative disc disease
- Persistent low back pain despite conservative treatment
- Discogenic pain confirmed through clinical evaluation
- Preserved spinal stability
- Preserved facet joint health
👉 Disc replacement is most successful in patients with isolated disc degeneration and without significant spinal instability.
SYMPTOMS THAT MAY RESPOND TO LUMBAR DISC REPLACEMENT
Common Symptoms
- Chronic low back pain
- Pain worsened by sitting
- Pain worsened by bending or lifting
- Mechanical back pain
- Reduced activity tolerance
Typical Pattern
- Symptoms are primarily back pain rather than leg pain
- Pain often persists despite medications, therapy, injections, and activity modification
- Imaging demonstrates degeneration at a specific disc level
🚨 When Disc Replacement May Not Be Appropriate
- Significant spinal instability
- Spondylolisthesis
- Severe facet arthritis
- Significant scoliosis or deformity
- Osteoporosis
- Multilevel degenerative disease
HOW IS THE PROCEDURE PERFORMED?
Step-by-Step Overview
Anesthesia
- Performed under general anesthesia
Anterior Approach
- Access to the spine is obtained through the abdomen
- An access surgeon is involved – who is very experienced with abdominal surgery
Disc Removal
- The damaged disc is completely removed
Preparation
- The vertebral endplates are carefully prepared
Artificial Disc Placement
- The artificial disc is positioned between the vertebrae
- Implant placement is confirmed using imaging guidance
Closure
- The incision is closed and dressings are applied
👉 The artificial disc is designed to restore disc height while allowing controlled motion.
OUR APPROACH
Not every patient with degenerative disc disease is a candidate for lumbar disc replacement.
We carefully evaluate:
- The source of pain
- Degree of disc degeneration
- Facet joint health
- Spinal alignment
- Stability of the spine
- Bone quality
Patients who are not ideal candidates for disc replacement may achieve better outcomes with other procedures such as fusion surgery.
👉 Our goal is to identify patients who are most likely to benefit from motion preservation while avoiding unnecessary surgery.
WHAT TO EXPECT
Before Surgery
- MRI of the lumbar spine
- Standing X-rays
- Evaluation of spinal stability
- Assessment of facet joints
- Bone density evaluation when appropriate
Day of Surgery
- Performed under general anesthesia
- Typically involves an anterior abdominal approach
- Implant position is confirmed during surgery
After Surgery
- Walking begins shortly after surgery
- Hospital stay is often short
- Activity gradually increases over several weeks
- Recovery continues over several months
OUTCOMES & RISKS
Potential Benefits
- Relief of low back pain
- Preservation of motion
- Restoration of disc height
- Improved function and mobility
- Potential reduction in stress on adjacent levels
- Avoidance of fusion-related stiffness
Risks
- Infection
- Bleeding
- Nerve injury
- Blood vessel injury
- Implant migration
- Implant wear or failure
- Persistent pain
- Need for revision surgery
- Conversion to fusion surgery
👉 Outcomes depend heavily on proper patient selection and accurate diagnosis of discogenic pain.
FREQUENTLY ASKED QUESTIONS
How is disc replacement different from fusion?
Fusion eliminates motion at a spinal level. Disc replacement is designed to preserve motion.
Am I a candidate for lumbar disc replacement?
Candidates generally have isolated degenerative disc disease without significant instability, deformity, or facet arthritis.
How long does an artificial disc last?
Modern artificial discs are designed for long-term durability, although all implants have the potential to wear over time.
Can lumbar disc replacement prevent adjacent segment disease?
Preserving motion may reduce stress on neighboring levels, although no procedure completely eliminates future degeneration.
What happens if the artificial disc fails?
Some patients may require revision surgery or conversion to a spinal fusion.
FOR REFERRING PHYSICIANS
Refer patients with:
- Single-level degenerative disc disease
- Chronic discogenic low back pain
- Failure of conservative treatment
- Preserved spinal alignment and stability
Imaging:
- MRI lumbar spine
- Standing lumbar radiographs
- Flexion-extension radiographs when indicated
- CT scan when needed
Consider:
- Facet joint health
- Presence of instability
- Degree of disc degeneration
- Bone quality
- Alternative treatment options including fusion
RELATED CONDITIONS / PROCEDURES
- Degenerative Disc DiseaseLumbosacral disc degeneration
- Chronic Low Back Pain
- Anterior Lumbar Interbody Fusion (ALIF)
- Lumbar Fusion