Disc replacement surgery offers an alternative to spinal fusion where, instead of using bone grafts, artificial discs are implanted in place of the diseased disc to restore normal disc height and preserve the natural motion of the spine.
Disc replacement surgery is a procedure where the worn or diseased disc is removed and replaced with an artificial disc implant to relieve neck and back pain, restore normal disc height, preserve spine mobility, and improve patient function. Disc replacement surgeries can be performed in the cervical (upper) or lumbar (lower) spine. This surgery is usually recommended for eligible patients experiencing chronic neck or back pain who have not found relief after a prolonged period of conservative treatment.
An artificial disc is a prosthetic implant designed to replace the damaged disc in the spine and help preserve its natural motion. Artificial discs can be made of metal, plastic, or both. A prosthetic disc implant constructed from both metal and plastic is usually made up of a sliding core (derived from a medical grade plastic) and two metal endplates (derived from medical grade cobalt chromium or titanium alloy) on each side. Your surgeon will discuss the most suitable artificial disc for you.
Generally, disc replacement surgery is recommended for patients who:
Depending on the severity of the condition, the doctor may recommend disc replacement in suitable cases of:
In preparation for surgery, your doctor will discuss the procedure, its potential risks and complications, and the realistic expectations after surgery. It is also crucial to discuss any medicines, supplements, or blood thinners you are taking with your doctor during this time. Your doctor may advise you to stop taking certain medications prior to the operation if they may affect healing or blood clotting. You should also inform your doctor about any allergy to medications, food, or latex to avoid complications.
If you smoke, you may be advised to quit smoking for about 4-6 weeks before surgery, since it can increase the risk of postoperative complications. Finally, you will be required to avoid eating or drinking for at least 8 hours before the procedure.
Disc replacement surgeries are typically done under general anaesthesia and take about 1-3 hours to complete.
The surgeon creates a small incision over the front of the neck during surgery. Afterwards, the soft tissues of the neck, including the oesophagus, trachea, and blood vessels are moved to the side. This allows access to the spine without affecting the nerves and other tissues. Once the appropriate spinal level is identified, the diseased disc is removed and replaced with a new artificial disc. A fluoroscope will be used to provide an X-ray image of the disc to ensure the accuracy and safety of the procedure. The organs and blood vessels are then put back in place and the incision is closed.
Typically, lumbar disc replacement surgeries are performed with the assistance of a vascular or abdominal surgeon. The incision is made in the abdomen, and vital organs, blood vessels, and nerves are carefully moved to one side of the abdomen to provide access to the front portion of the spine. Similar to cervical disc replacement, a fluoroscope will be used to ensure accuracy during the operation. The surgeon removes the diseased disc and implants the artificial disc in place. Afterwards, the abdominal organs and blood vessels are put back in place and the incision is closed.
After surgery, the patient will be taken to a recovery area for monitoring until the anaesthesia wears off. Some
patients may be allowed to go home after surgery, while some will be required to stay in the hospital for a few days
after surgery. Medicines will also be given to reduce post-operative pain.
To aid in recovery, the patient will be encouraged to stand and walk within the first day after surgery. A
physiotherapist will guide the patient on proper movements and exercise techniques to improve their flexibility and
strength and speed up recovery. Typically, patients recover from the surgery in about 3-5 weeks to a maximum of 3
months after the procedure.
Some cases may be treated non-surgically. However, in other cases, surgery may be required if the condition is serious, or if the patient does not respond well to conservative treatments. Consult a specialist to determine the most effective course of treatment.
Artificial discs have an average lifespan of about 5-15 years. For some patients, however, disc replacements can last a few decades. Regular follow-ups with your surgeon can help to monitor the condition of your artificial disc and natural spine.
Disc replacement surgery is considered a very effective and safe procedure, with a success rate of over 90% in cases of cervical disc replacements, according to the US Food and Drug Administration.
Cervical disc replacements are more commonly performed than lumbar disc replacement, and it involves replacing the discs in the upper spine or the neck portion of the spine.
Dr Chua Soo Yong is an orthopaedic and spine surgeon with over 10 years of specialist experience. With subspecialty knowledge in spinal surgery, Dr Chua has performed numerous disc replacement surgeries with positive outcomes. Dr Chua remains actively involved in research and academia, publishing several articles on spine conditions and regeneration. Currently, he sits as a faculty member at AOSpine and is an orthopaedic surgeon and spine specialist at Mount Elizabeth Hospital, Singapore.
3 Mount Elizabeth Suite #06-09,
Mount Elizabeth Medical Centre
Singapore 228510
