Overview and Indications
Artificial disc replacement (ADR) is newer type of spinal disc procedure that utilizes an anterior approach to replace a painful, arthritic and worn-out intervertebral disc of the lumbar spine with a metal and plastic prosthesis (artificial disc).
Artificial disc replacement is primarily considered for patients with isolated 1-level (one disc only) degenerative disc disease. Prior to the development of ADR, spinal fusion was the principal treatment for painful degenerative disc disease that failed to improve with nonoperative management. ADR is generally NOT recommended for patients with spinal fractures, instability, neurologic compression or multiple level degenerative disc disease. Spinal fusion remains the treatment of choice for these conditions. The advantages of ADR include a faster recovery time than spinal fusion and preserved motion at the disc level. The theoretical long-term advantage of ADR, which remains unproven, is the possibility of decreased adjacent level stress and arthritis compared with spinal fusion.
Most patients are usually able to go home two to four days after surgery. Before patients go home, physical therapists and occupational therapists work with patients and instruct them on proper techniques of getting in and out of bed and walking independently. Patients are instructed to avoid bending at the waist, lifting more than five pound and twisting in the early postoperative period (first two to four weeks) to avoid a strain injury. Patients can gradually begin to bend, twist and lift after four to six weeks as the pain subsides and the back muscles get stronger.
Patients are generally not required to wear a back brace after surgery. Patients may be issued a soft lumbar corset that can provide additional lumbar support in the postoperative period, if necessary.