Intervertebral disc arthroplasty

Intervertebral Disc Arthroplasty is a surgical procedure aimed at relieving pain and restoring function in patients with degenerative disc disease (DDD) of the spine. This procedure, also known as artificial disc replacement (ADR), involves replacing a damaged or diseased intervertebral disc with an artificial disc to preserve motion at the disc space. It is an alternative to spinal fusion, a more traditional surgery that eliminates motion at the affected vertebral segment.

Overview

The intervertebral discs are soft, compressible discs that separate the interlocking bones (vertebrae) of the spine. They act as shock absorbers for the spine, allowing it to flex, bend, and twist. Degenerative disc disease can cause the discs to become damaged and lead to pain, instability, and reduced mobility.

Intervertebral disc arthroplasty is performed with the goal of alleviating pain while maintaining more natural spine movement than is possible with spinal fusion. By preserving motion, the surgery aims to reduce the risk of adjacent segment degeneration, a condition where discs adjacent to a spinal fusion site degenerate at an accelerated rate.

Indications

Candidates for intervertebral disc arthroplasty typically have chronic, severe pain from degenerative disc disease that has not responded to conservative treatment measures such as physical therapy, medications, and spinal injections. The procedure is most commonly performed on the lumbar (lower back) or cervical (neck) regions of the spine.

Procedure

Under general anesthesia, the surgeon accesses the spine through an incision in the abdomen (for lumbar arthroplasty) or the neck (for cervical arthroplasty). The damaged disc is removed, and the artificial disc is inserted into the empty disc space. The artificial disc is designed to mimic the form and function of a natural disc, allowing for normal range of motion.

Types of Artificial Discs

There are several types of artificial discs used in intervertebral disc arthroplasty, including:

• Metal-on-metal
• Metal-on-plastic
• Biopolymer materials

Each type has its own advantages and potential drawbacks, and the choice of artificial disc may depend on the patient's specific condition and the surgeon's preference.

Risks and Complications

As with any surgical procedure, intervertebral disc arthroplasty carries risks and potential complications. These may include:

• Infection
• Bleeding
• Nerve damage
• Artificial disc displacement or malfunction
• Persistent pain

Recovery

Recovery from intervertebral disc arthroplasty varies depending on the individual patient and the specific procedure performed. Patients typically participate in a rehabilitation program to strengthen the spine and restore function. Many patients experience significant pain relief and improved mobility after recovery.

Conclusion

Intervertebral disc arthroplasty offers a promising alternative to spinal fusion for patients with degenerative disc disease, providing pain relief and preserving spinal motion. However, it is important for patients to discuss the potential risks and benefits of the procedure with their healthcare provider to determine if it is the right option for them.