What is a Lumbar Artificial Disc Replacement (ADR)?
As a lower back surgeon, Dr. Braxton performs artificial disc replacement (ADR) for patients suffering from lumbar spine degenerative disease. The goal of this surgical procedure is to improve the function of the lumbar spine with increased range of motion and load capacity to the lower back. Dr. Braxton works closely with patients to determine if artificial disc replacement is the recommended course of treatment.
There are a number of surgical artificial disc replacement techniques that Dr. Braxton may recommend. The right treatment plan will be recommended depending on a patient’s condition. Two common options of lumbar artificial disc replacement include a lumbar disc nucleus artificial replacement and a total lumbar disc artificial replacement. A lumbar disc nucleus artificial replacement involves removing the diseased disc nucleus and inserting the artificial disc nucleus in the disc space between adjacent vertebrae. In this case, the outer band disc (the annulus) is not removed. A total artificial disc replacement involves the removal of all or the majority of the disc material.
Both the artificial disc nucleus and the total artificial disc devices are made of materials that have a high success rate for patient outcomes. The total artificial disc device has a top and bottom metal plate designed to attach with adjacent levels of the lumbar spine. The artificial nucleus device design replicates the normal disc with a soft, compressible interior and a smooth, curved outer surface. The artificial disc nucleus has organic hydration capabilities of a healthy disc which helps facilitate the overall function of the disc. Dr. Braxton’s patient evaluation will determine which lumbar artificial disc replacement is the best choice for optimal outcome.
Am I a Candidate for Lumbar Artificial Disc Replacement?
Dr. Braxton works closely with patients to determine eligibility for a lumbar artificial disc replacement (ADR) surgery. Candidates for this procedure typically report:
- Diagnosis of lumbar degenerative disc disease or trauma
- Symptoms of lumbar spinal pain, stenosis, myelopathy or radiculopathy
- Prior failed procedures
- Limited success with non-surgical treatments:
- Anti -inflammatory and pain medications
- Injection therapies
- Chiropractic and physical therapies
Dr. Braxton uses a range of diagnostic tools such as patient history, symptoms, imaging and nerve studies to determine the specifics of the surgical recommendation for the patient. Some patients have contraindications affecting eligibility for the procedure.
These can include:
- Bone loss or osteoporosis
- Fracture of vertebrae
- Slipping of vertebrae across lower level or spondylolisthesis
- Spinal infection, tumor or autoimmune issues
- Allergy to device components
- Severe degeneration of facet joints
- Overuse of steroids
- Pregnancy
- Obesity
Dr. Braxton offers patient care and education to address contraindications such that eligibility may be restored. His goal is to provide the patient with the best possible outcome in managing lumbar degenerative disc disease.
How is an Artificial Disc Replacement Performed?
Dr. Braxton carefully prepares patients for lumbar artificial disc replacement surgery. This includes comprehensive patient education and a full explanation of expected surgical outcomes. This surgery requires general anesthesia. Typically it is a 2 to 3 hour procedure requiring a 1 to 3 day hospital stay. The patient is on their back for the surgery. Using an anterior approach, the initial goal is to access the lumbar spine while protecting internal organs, blood supply and spinal nerves. Once the internal surgical site is prepared the diseased disc, or disc nucleus, is removed and the artificial device is implanted into the disc space. Once the procedure is completed the incision is sutured and the patient is placed into post-surgery care.
What is the Recovery Like After ADR?
The gradual return to activities should include a light walking routine, increasing over time, and a prescribed stretching routine; physical therapy may be also prescribed. Pain management needs will diminish over time. Following the procedure, patients begin to experience a decrease in their preoperative lumbar pain level and an increase in lower back movement. These improvements continue for weeks to months as the lumbar artificial disc replacement heals. Compared to a bone fusion, there is a reduction in complications in artificial disc replacement. A majority of artificial disc replacement patients report being highly satisfied with the results of the surgery.