Lumbar Disc Replacement

WHAT IS THE ROLE OF LUMBAR DISC IN THE SPINE?
Spinal column is one of the crucial parts of the human body as it enables body movement. It is a column of bony vertebrae that supports the body structure, and protects the spinal cord. Lumbar spine is the part of the spine, commonly referred to as your lower back. It consist of five large vertebrae. Lumbar discs or intervertebral discs are positioned between the spinal column and are responsible for padding the spine and making it flexible. These discs have a soft center that is encircled by tough outer rings.The nerves branch out and pass from the vertebrae aperture to other parts of the body.

WHAT ARE THE CAUSES OF LUMBAR DISC DEGENERATION?
Lumbar disc degeneration is usually caused due to water-loss in the discs with age or due to disease. This results in the narrowing of space between the vertebrae. Consequently, the nerve aperture gets constricted. Disc degeneration is also caused due to incorrect sitting posture and body movements or injury usually to the lower back. All these conditions lead to spinal dysfunction that impedes normal daily activities.

HOW CAN DISC DEGENERATION BE TREATED?
Lumbar degenerative diseases can be treated by non-surgical procedures, viz. physical exercises and therapy or medications for keeping a check on inflammation and pain.Your doctor will design a treatment plan for you after conducting a comprehensive examination, taking into account your medical history. In case the non-surgical treatment doesnt help, you can go in for a surgical procedure.

WHAT IS LUMBAR DISC REPLACEMENT OR ARTIFICIAL DISC REPLACEMENT SURGERY?
Lumbar Disc Replacement is similar to any other type of joint replacement (Hip and Knee). Artificial Disc Replacement System is a cushioning device that is inserted in place of the degenerated discs to allow normal spine movement.These artificial discs comprise two adjacent sections made of cobalt-chrome-molybdenum alloy, each section having two diverse surfaces. The flat surfaces join to form a sphere and the socket facilitates spine movement, while the textured sides fit against the bony vertebra over and below the damaged disc space and allows the bones to attach to the implant.

WHO CAN UNDERGO ARTIFICIAL DISC REPLACEMENT SURGERY?
If you have pain in your lower back or leg, experience lack of sensation in your legs or buttocks and are unable to walk properly, you may have Degenerative Disc Disease. Your surgeon will examine you thoroughly to confirm the diagnosis. Generally, the surgeon recommends the disc replacement surgery only after six months, in case there is no improvement in your condition with physical therapy and exercises or inflammatory and pain relief medications.

WHAT HAPPENS DURING THE SURGERY?
During the surgery, once you are anaesthetised the surgeon will make a small incision in your abdomen. Thereafter, he will examine an x-ray of the spine to carefully detect the degenerated parts of the discs. Once the examination is complete, your surgeon will remove the degenerated discs, measure the disc space and replace them with Artificial Disc Replacement implants. Your surgeon may take another x-ray to re-examine the correct positioning of the artificial disc implant

WHAT HAPPENS AFTER THE SURGERY?
Once you recover from anaesthesia, you will be transferred to your room. The surgeon will give you post-operative instructions and prescribe medications to provide you relief from nausea and pain. Furthermore, the doctor will advise you to slowly increase your daily activity but refrain from strenuous activities like bending, lifting, twisting, driving and other sports activity till the time you recover completely.

You may visit a physical therapist on the doctor's advice, to practice some toning exercises for the abdomen, to learn different postures of sitting, standing and lifting in order to avoid further injury on the operated area.

HOW LONG DOES IT TAKE TO RECOVER COMPLETELY?
The recovery rate is different for different individuals. Several factors that influence your recovery include your age, fitness level, and your commitment to follow the surgeon and physical therapist's instructions. Generally, once you are able to sit, stand, walk and bend comfortably, you will be discharged from the hospital.

WHAT IS SPINAL FUSION?
Spinal fusion is a procedure done to remove damaged disc and stimulate bone growth in that area. Fusion will lock the vertebra above and below the damaged disc to disallow any motion at the spinal level.Thus allowing excellent pain relief.

WHAT ARE THE BENEFITS OF ARTIFICIAL DISC REPLACEMENT SURGERY OVER SPINAL FUSION?
Artificial Disc Replacement surgery is an alternative to the fusion surgery that is generally performed for disc degeneration. The aim of lumbar disc replacement is to recreate normal dynamic function. The advantage of lumbar disc replacement over spinal fusion is that the replaced disc would allow motion at the damage level and would not transfer stress to the adjacent level. The goal is to achieve the same pain reduction as spinal fusion but eliminate some of the complications associated with fusion. This surgery is beneficial as it protects the discs from further degeneration due to mechanical or any other stress.

IN WHAT CONDITIONS ARTIFICIAL DISC REPLACEMENT CANNOT BE PERFORMED?
Artificial Disc Replacement cannot be done in following conditions:

• Spondylolisthesis (the slipping of one vertebral body across a lower one)
• Osteoporosis
• Vertebral body fracture
• Allergy to the materials in Artificial Disc Replacement device
• Spinal tumor
• Spinal infection
• Morbid obesity
• Changes in facet joints
• Pregnancy
• Constant steroids use

ORTHOPAEDIC CARE AT ARTEMIS
AHI is a centre of excellence for Orthopaedic care. It has a highly qualified and well trained team of Orthopaedicians with expertise in Trauma Care, Joint Replacement Surgery, Spine Surgery and Minimally Invasive Orthopaedics Surgery. It also has a large and well equipped Physiotherapy unit for quick Rehabilitation and Recovery.

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Team of Specialists:

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