What is spinal artificial disc replacement?

What is spinal artificial disc replacement?

‍

Spinal artificial disc replacement, also known as total disc replacement or disc arthroplasty, is a surgical procedure performed to treat certain spinal conditions, particularly degenerative disc disease (DDD). DDD is a common condition in which the intervertebral discs, which act as cushions between the vertebrae of the spine, become worn out and lose their ability to provide proper support and shock absorption resulting in back pain, limited range of motion and impingement of the neural structures. It can be attributed to aging, mechanical overloading and genetic factors.

‍

During a spinal artificial disc replacement surgery, the damaged or diseased natural disc is removed and replaced with an artificial disc implant. The goal of this procedure is to relieve pain, restore spinal stability, and maintain normal motion and flexibility in the affected spinal segment.

‍

The surgery is typically performed through an anterior (front) approach, accessing the spine through the abdominal or neck region. The surgeon will carefully remove the damaged disc, taking care not to damage nearby nerves or structures. Then, the artificial disc implant is inserted into the empty disc space. The implant is designed to mimic the function of a natural disc, allowing for controlled motion and maintaining the normal alignment of the spine.

‍

Artificial disc replacement is considered an alternative to traditional spinal fusion surgery, which involves permanently fusing two vertebrae together after removing the disc. In contrast, disc replacement aims to preserve the natural movement of the spine, potentially reducing stress on adjacent spinal segments and potentially decreasing the risk of adjacent segment degeneration.

‍

As with any surgical procedure, there are potential risks and complications associated with spinal artificial disc replacement. Patients considering this procedure should undergo a thorough evaluation by a spine specialist to determine if they are suitable candidates and to fully understand the benefits and potential risks involved.

‍

Who can benefit from spinal artificial disc replacement?

‍

Spinal artificial disc replacement can benefit individuals who have specific spinal conditions, particularly single-level degenerative disc disease (DDD), and meet certain criteria. The procedure is typically considered for patients who:

‍

1. Have Degenerative Disc Disease: Artificial disc replacement is most commonly performed for degenerative disc disease, a condition in which the intervertebral discs of the spine degenerate, causing pain, reduced mobility, and potential nerve compression.
2. Have Failed Conservative Treatments: Patients who have not experienced sufficient relief from non-surgical treatments, such as physical therapy, medications, and injections, may be considered for artificial disc replacement when their symptoms persist.
3. Have Disc-Related Symptoms: Individuals experiencing symptoms directly related to disc degeneration, such as chronic neck or back pain, radiculopathy (nerve root compression leading to radiating pain), or arm or leg weakness, may benefit from the procedure.
4. Have Single-Level Involvement: Artificial disc replacement is typically performed on a single spinal level. It is not recommended for individuals with multi-level disc degeneration or severe spinal instability.
5. Are Not Suitable Candidates for Fusion Surgery: Some patients may not be suitable candidates for traditional spinal fusion surgery due to the potential risk of increased stress on adjacent spinal segments, which could lead to adjacent segment degeneration. In such cases, artificial disc replacement may be a more appropriate option to preserve spinal mobility.
6. Have Healthy Adjacent Discs: For the best results, patients should have relatively healthy adjacent discs that can provide adequate support to the artificial disc and prevent excessive stress on the replacement disc.
7. Are in Generally Good Health: Patients considered for artificial disc replacement should be in overall good health and have no contraindications to surgery.

‍

It's important to note that not all patients with degenerative disc disease are suitable candidates for artificial disc replacement. The decision to undergo this procedure should be made in consultation with a spine specialist who has experience with artificial disc replacement. The surgeon will thoroughly assess the patient's spinal condition, medical history, response to conservative treatments, and overall health to determine if spinal artificial disc replacement is the most appropriate treatment option for their specific case. Each patient's unique condition and individual health factors will influence the suitability and success of the procedure.

‍

After spinal artificial disc replacement: What to expect

‍

After spinal artificial disc replacement surgery, the recovery process is crucial to ensure proper healing and successful rehabilitation. Here's what you can generally expect during the recovery period:

‍

1. Hospital Stay: Spinal artificial disc replacement surgery is typically performed in a hospital setting. The length of the hospital stay may vary depending on the surgical approach, the complexity of the procedure, and your surgeon's preferences.
2. Pain Management: You may experience some pain and discomfort at the surgical site. Your healthcare team will prescribe pain medications to manage post-operative pain.
3. Activity Restrictions: After surgery, you will likely be advised to limit certain activities and movements to protect the surgical site and allow for proper healing.
4. Physical Therapy: Physical therapy is an essential part of the recovery process. A physical therapist will guide you through exercises to promote healing, improve mobility, and strengthen the muscles supporting the spine.
5. Walking and Mobility: Early mobilization is encouraged after surgery. You may be assisted to stand and walk with the help of a physical therapist or nurse, gradually increasing your walking distance as you heal.
6. Follow-up Appointments: You will have regular follow-up appointments with your surgeon to monitor your progress, check the surgical site, and discuss any concerns or questions.
7. Gradual Return to Activities: The timeframe for returning to normal activities will vary depending on the extent of the surgery and your individual healing process. Your surgeon will provide guidelines for a gradual return to daily activities, work, and exercise.
8. Incision Healing: You will need to care for the surgical incision as directed by your surgeon to promote proper healing and minimize scarring.
9. Pain and Symptom Improvement: You may experience gradual improvement in pain and symptoms related to your degenerative disc disease as you heal and recover from surgery.
10. Timeframe for Full Recovery: The recovery period varies from person to person and depends on the extent of the surgery and individual healing factors. Most individuals can expect to see continued improvement in the weeks and months following surgery.

‍

It's essential to follow your surgeon's instructions diligently and attend any scheduled follow-up appointments to ensure a successful recovery. Adhering to post-operative care guidelines and participating in physical therapy exercises will lead to the best possible outcome, allowing you to regain mobility and gradually resume your normal activities with reduced pain and improved spinal function.

‍

How can physical therapy help? 

‍

Physical therapy plays a crucial role in the recovery process after spinal artificial disc replacement surgery. A physical therapist will design a customized rehabilitation program to promote healing, restore spinal strength and flexibility, and guide you back to your normal activities. Here's how physical therapy can help with recovery from spinal artificial disc replacement:

‍

1. Pain Management: Physical therapists use various modalities such as ice, heat, ultrasound and electrical stimulation to manage post-operative pain and reduce muscle tension around the surgical site.
2. Bed Mobility Exercises: Part of the initial postoperative rehabilitation program is the bed mobility exercises. The patient must learn how to perform bed mobility to facilitate trunk and limb control.
3. Mobility and Flexibility Exercises: Early after surgery, physical therapists focus on gentle range of motion exercises such as active range of motion with or without assistance to maintain  spinal flexibility and prevent stiffness. As the patient improves, progressive stretching and joint mobilization exercises are prescribed to increase the range of motion of the restricted tissues.
4. Core Stabilization and Strengthening: As healing progresses, physical therapists prescribe core stabilization and strengthening exercises to improve spinal muscle strength, endurance, and performance as well as stability to support the spine's natural curvature.
5. Postural/Kinesthetic Training: This type of training aims to develop proprioception (position sense) of spinal positioning, safe movement and postural control. Physical therapists work on postural awareness and education to help you maintain proper spinal alignment in all functional activities. 
6. Gait Training: Once the patient is allowed to walk, an assistive device is usually indicated to facilitate an erect posture and unload some of the stress on the surgical area. Gait training is essential to help the patient walk with the appropriate spinal mechanics, ensuring proper weight distribution and balance.
7. Gradual Exercise Progression: Your physical therapist will guide you in a step-by-step approach to resume activities, ensuring your safety and allowing adequate time for healing.
8. Scar Tissue Management: Physical therapists may perform scar tissue mobilization techniques after the incision site is healed, to improve connective tissue mobility as well as to promote tissue healing and reduce scar adhesions.
9. Aerobic Conditioning: After periods of bed rest and immobilization, patients usually have a decreased cardiopulmonary endurance. Aerobic conditioning exercises are initiated as soon as the patient tolerates repetitive activity without pain and discomfort. Emphasizing safe spinal postures while exercising. This type of exercise helps the patient to improve cardiopulmonary endurance.
10. Post-operative Precautions: Your physical therapist will provide guidance on specific post-operative restrictions and precautions to protect the surgical site during the recovery phase.
11. Functional Training: A final component of an individualized rehabilitation program involves practicing activities that simulate the physical demands of a patient’s work or desired recreational activities. Simulated activities and drills enable a patient to practice under supervised conditions to receive feedback on correct mechanics. 
12. Education and Lifestyle Modification: Physical therapists educate patients about spinal artificial disc replacement, its indications and benefits as well as the role and importance of postoperative rehabilitation programs. They also teach the patients about maintaining a healthy lifestyle, proper ergonomics, body mechanics and strategies to prevent future spine-related issues.
13. Home Exercise Program: Physical therapists provide a specialized home exercises program and teach the patients how to safely and effectively incorporate it into their daily routine to reinforce the interventions and promote optimal recovery.
14. Progress Monitoring: Physical therapists continually monitor your progress and adjust the treatment plan as needed to ensure a successful recovery.

‍

Physical therapy is essential to optimize your recovery after spinal artificial disc replacement surgery. The therapist's expertise and guidance are instrumental in promoting healing, preventing complications, and helping you regain spinal strength, flexibility, and mobility. Consistent participation in physical therapy exercises and adherence to your therapist's recommendations will lead to the best possible outcome, allowing you to gradually resume your normal activities with reduced pain and improved spinal function.

Trust PeteHealth for recovery from spinal artificial disc replacement

Looking for a physical therapist to help you recover from spinal artificial disc replacement? PeteHealth is the trusted physical therapy solution that you can access on your schedule, bringing you the care you need wherever you need it – including your home or office. Our licensed physical therapists are at the top of their profession, and we accept most insurance carriers.

‍

Finally – the all-in-one, professional, convenient approach to physical therapy that you deserve with PeteHealth.

‍