Spinal arthroplasty, also known as artificial disc replacement (ADR), is the replacement of a damaged intervertebral disc with an artificial disc. Low back pain is one of the most common health issues for both young and old people. In this article, Dr. Giner explains the details and purpose of spinal arthroplasty surgery.
Arthroplasty is the medical term for the total replacement of a degenerated joint. The use of prostheses is required, so key factors such as biomechanics, prosthetic design, metallurgy and biomaterials must be taken into account in arthroplasty surgery.
The main objective of arthroplasty is to repair the damaged joint and relieve pain in the affected areas necessary for the mobility of the human body, such as the knee, elbow, hip or, in our case, as neurosurgeons, the spine.
Dr. Javier Giner García, a neurosurgeon specializing in minimally-invasive spine surgery, explains more about what spinal arthroplasty consists of.
When is spinal arthroplasty recommended?
The spine is composed of 33 vertebrae, with an intrevertebral disc between each set of them. Age, genetics, and daily wear and tear can all contribute to disc damage and degeneration or herniation. This degeneration, or disc herniation, can cause pain, weakness, and numbness that can spread to the limbs: the arms, in the case of cervical disc hernias, or legs in the case of lumbar disc hernias.
Many patients with degenerated or herniated discs respond well to conservative and nonsurgical treatments, such as physical therapy, infiltrations, and neck or lumbar braces. These procedures are often effective in relieving aches and pains and symptoms, and avoid the risks involved in a surgical procedure.
But, if patients suffer severe pain in the neck and/or arms, or severe pain in the lumbar area that also affects the legs, and non-surgical treatments are not enough to relieve the patient's symptoms, that is when arthroplasty is considered.
There are other types of surgery that can be used, and while young patients with only one or two herniated discs and an otherwise healthy spine are usually candidates for arthroplasty, in the case of older patients with pathologies such as arthritis, bone spurs, or limited mobility, other procedures are generally chosen.
Cervical arthroplasty
There are several treatment options for the degeneration of a disc in the cervical spine that compresses the spinal cord and nerves, and cervical arthroplasty surgery is one of them. In this surgery, the damaged disc is removed and replaced with a prosthesis that mimics the movement of the healthy natural disc.
At Instituto Clavel, artifical disc replacement (ADR) is our surgical technique of choice, if the patient is a suitable candidate. This is because it is a less invasive procedure than fusion surgery, and unlike fusion surgery, it allows the spine to maintain its natural mobility.
Lumbar arthroplasty
Lumbar arthroplasty, as its name suggests, involves replacing a worn or degenerated disc in the lumbar spine, with an artificial disc made of metal, or a combination of metal and plastic. As with cervical arthroplasty, it is considered as an alternative to spinal fusion surgery.
The main reason a patient would need lumbar disc replacement is to treat low back pain. This surgery is indicated for cases of lumbar disc degeneration, with or without herniation, when non-surgical treatments are not effective and the pain is such that it affects the patient’s ability to carry out their normal daily activities. However, it is important to remember that not everyone with this condition is a good candidate for surgery.
In general, lumbar arthroplasty would be recommended only if the patient meets the following criteria: they have only one or two damaged discs in the lower back, they do not suffer from any joint disease or significant compression of the nerves of the spine, they are not overweight, they have not undergone spine surgery previously, and they do not suffer from scoliosis or some other spinal deformity.
At Instituto Clavel, once we determine that the patient meets the criteria mentioned above, we prioritize the option of disc replacement surgery, because it is a less invasive procedure than fusion surgery, and it allows the spine to preserve its natural movement. In fact, at Instituto Clavel we are specialists in this surgery, and there are very few other centers in Europe with personnel trained in this tehnique.
What to expect when you have arthroplasty, or disc replacement surgery at Instituto Clavel
This is a planned surgery. Before having this surgery, the patient must first have an appointment with the surgeon so that the surgeon can learn all the details of the patient’s medical history, in order to recommend the best procedure for their case. Once the decision is made to go ahead with the surgery, a date will be agreed on, and the patient will be admitted to the hospital on the day of the surgery.
ADR surgery usually lasts about an hour when operating at either the lumbar or cervical level. When more than one disc is involved, each extra level adds about a half hour more. Once the operation is over, the patient is transferred to the recovery room, and after about two hours, they will be moved to their hospital room. Discharge from the hospital is usually 1 to 3 days after the surgery.
Recovery following arthroplasty surgery is a gradual process, and some discomfort is normal. The patient will have a follow-up visit 7 or 10 days after the operation, to have the stitches removed and to check the healing of the surgical incision.
Learn more about disc replacement surgery in this article:
Everything you need to know about ADR surgery
Dr. Clavel explains the procedure of lumbar arthroplasty or disc replacement surgery in this video.
At Instituto Clavel we believe that ADR surgery, with the total (or almost total) replacement of the disc by an artificial prosthesis, is the operation of choice in cases of lumbar and cervical degenerative disc disease. With the surgery, the joint’s ability to move naturally is maintained, and the outcome is satisfactory in more than 95% of cases. We accompany our patients with postoperative physical therapy provided by the team at IC Rehabilitation.
Do you need more information? Please don’t hesitate to contact the Instituto Clavel team if you have any questions about spinal arthroplasty. We have the answers!
Categories: Spine treatments, Spine pathologies, Surgery