Artificial Disc Replacement Surgery – 4 Key Considerations

The decision to undergo spine surgery is a deeply personal one. Having performed procedures now numbering in the thousands, I can state with genuine humility that all cases are unique. While the patients’ anatomy may be similar, each decides to undergo surgery from a unique set of circumstances, backgrounds, and life goals. However, if you are experiencing persistent back pain, and have been told that artificial disc replacement surgery might be right for you, below are four factors that may indicate the procedure’s potential benefits. 

Radiating Back Pain: Does the back pain you’re experiencing also seem to travel up and down your arms or legs? In some cases, damage or injury to the spine can cause it to place pressure on the nerves that surround it. When spinal nerves are compressed, pain, shooting, stinging, and burning sensations can extend from the back to the extremities. In many cases, the underlying cause must be treated for the pain to subside.

Herniated Disc Disease: Herniated discs occur with the gel-like center of a spinal disc breeches the more rigid exterior either through a crack in the disc or as the result of traumatic injury. Leakage of herniated disc material can place pressure on the spinal nerves and lead to radiating pain, as described above.

Conservative Treatment Failure: If you find yourself frequently taking anti-inflammatory medications that don’t seem to dull the back pain you’re experiencing, or if other conventional treatments have failed to provide the relief you need to live a normal and active life, it may be time to explore surgical options – including artificial disc replacement surgery.

Degenerative Disc Disease: The “Gold Standard” in the surgical treatment of degenerative disc disease has been spinal fusion for many years. Spinal fusion is a surgical procedure wherein the surgeon removes the damaged disc material from a person’s spine and then permanently “locks” two or more of the spine’s vertebrae together. Hence, they cannot move individually but as one fused unit. Fusing the damaged vertebra with the one above or below alleviates the pain associated with degenerative disc disease. 

Of course, eliminating pain is a critical goal in any surgical spine procedure, but movement restoration is crucial too. With younger and younger patients requiring surgery today, it isn’t enough for us spine surgeons to only reduce pain with surgery. We must also endeavor to restore the spine to as normal a range of motion as possible, which is the basis for healthy and active living. A healthy and “normal” spine allows for movement at each disc. But fusing the spine does have some well-known disadvantages, including the loss of motion and flexibility. Additionally, spinal fusion can increase the potential for other discs above and below the fused segment to be more burdened over time and degenerate more quickly, thus leading to more pain and possibly the need for future additional surgery.

Another procedure has been developed to minimize these spinal fusion disadvantages and risks. Artificial disc replacement surgery offers a viable alternative to the standard spinal fusion procedure in that it is reversible and directly replaces the damaged discs themselves rather than fusing vertebrae permanently. There are different types of artificial disc devices. Still, the primary goal of each is to replace a failing disc while acting as part of the spine’s “normal” anatomy, thus eliminating pain and restoring a more normal range of spinal motion for the patient, often leading to a better quality of life down the road. 

While artificial disc replacement can be a promising option for many patients, it isn’t suitable for everyone. For those who suffer from spondylolisthesis, osteoporosis, a previous spinal fracture, and other conditions that may affect the strength and integrity of the spine, artificial disc replacement may not be a viable option. Also, as with any surgical procedure, there are risks involved with artificial disc replacement surgery. Understanding and discussing these risks with an expert spine surgeon as you weigh your options is essential. No matter your age, “living with” debilitating back pain for the rest of your life should not be the treatment option anyone chooses. 


Neel Anand MD