Artificial Disc

An artificial disc is a specially designed synthetic apparatus which is employed to surgically substitute the damaged intervertebral disc and facilitate the decompression of the spinal cord and/or spinal nerve roots. The objective of artificial disc replacement is to reduce the pain and to preserve the mobility of the spine in patients with chronic back pain. Artificial discs are an advanced alternative to spinal fusion surgery, which uses bone grafts, plates and screws. The artificial disc replacement is also known as disc arthroplasty.

Spinal intervertebral discs are present in between two adjoining vertebrae and act as a shock absorber between them, they also provides tractability and mobility to the spinal column. With aging, degenerative disc changes can occur and cause a weakening, tear and bulging of the disc resulting in pain.

Artificial disc replacement is not recommended in patients suffering with kyphosis, severe stenosis with spinal instability, dynamic facet joint arthritis, or bone infection.

Procedure

During artificial disc replacement surgery, a small incision is made over the skin, on the back, to approach the spine. X-ray imaging is used to identify the injured intervertebral disc. A special microscope is used for visualizing the area under operation. The complete intervertebral disc is removed and the space created is adjusted for the insertion of an artificial disc under fluoroscopic guidance. The accurate placement of the artificial disc is confirmed by X-ray imaging. After the procedure, the muscles and soft tissues are placed in their respective positions and the wound is sutured.

There are various types of disc designs and each has its specific advantages and limitations. Some artificial discs are composed of metal while others are made of a combination of metal and plastic.

Post operative care

Generally, patients may be discharged home in a day or two of the surgery. Most of the patients undergoing this procedure have a quick recovery and can walk after a few hours of the surgery.
Some general postoperative instructions include:

• Restrict movement of the operated segment of the spine for a few weeks
• Use a brace to support the spine and enhance healing
• Avoid heavy lifting for 3-4 weeks
• Avoid heavy work for at least 6 weeks

Risks and Complications

Some of the complications associated with artificial disc replacement surgery include infection, spinal nerve injuries, improper implantation (requires revision surgery), and sinking of the spine (subsidence).