Spine Treatment
Surgical Treatments

ARTIFICIAL DISC REPLACEMENT in the LUMBAR SPINE

Low back pain is a significant cause of disability in the U.S. and worldwide. It is estimated that 70% to 80% of people will experience low back pain at some point in their lives.

Artificial disc replacement is a newer surgical procedure for relieving low back pain. Similar to hip or knee joint replacements, a disc replacement substitutes a mechanical device for an intervertebral disc in the spine. The device is meant to restore motion to the spine by replacing the worn, degenerated disc. 

It is typically seen in the lower back and is usually accompanied by straightening of the spine from the side. Pain, stiffness, numbness and shooting pain down the legs are seen in symptomatic patients (SRS, 2015).

CONSULT

To determine who is a good candidate for disc replacement, the surgeon may require a few tests. These may include magnetic resonance imaging (MRI), discography, computed tomography (CT or CAT scan), and x-rays. These tests will also help the surgeon determine the source of the pain.

Good candidates for disc replacement have the following:

  • Back pain thought to be caused mostly from one or two intervertebral discs in the lumbar spine
  • No significant facet joint disease or bony compression on nerves
  • Not excessively overweight
  • No prior major surgery in the lumbar spine
  • No deformity (scoliosis)

TREATMENT

Artificial disc replacement has emerged as an alternative treatment option to lumbar fusion surgery for low back pain.

Lumbar fusion surgery remains the “gold standard” for treating low back pain patients who are not helped by nonsurgical methods and many people find relief with lumbar fusion, however the results of fusion surgery vary. For example, a patient with spinal stenosis who has a fusion procedure may have a very different outcome from a patient who has a fusion to help back pain that is caused by disc degeneration. In addition, some patients whose fusion surgeries heal perfectly still end up with no improvement of their back pain.

Herniated Disc in Spine

The artificial disc offers several theoretical benefits over the spinal fusion for chronic back pain, including:

  • Potentially enhanced clinical success rates (pain reduction)
  • Potential to avoid premature degeneration at adjacent levels of the spine by maintaining normal spinal motion

PROCEDURE/TECHNIQUE

The surgical implantation procedure is performed through an incision in the abdomen (similar to an anterior lumbar interbody fusion).

With this approach, the organs and blood vessels must be moved to the side. This allows your surgeon to access the spine without moving the nerves.

Usually, a vascular surgeon assists the orthopaedic surgeon with opening and exposing the disc space. Most surgeries take about 2 to 3 hours.

Disc Design
The disc replacement device may comprise the nucleus (center) of the disc while leaving the annulus (outer ring) in place, although this technology is still in an investigative stage.

In most cases, total artificial disc replacements substitute the annulus and nucleus with a mechanical device that will simulate spinal function.

There are a number of different disc designs. Each is unique in its own way, but all maintain a similar goal: to reproduce the size and function of a normal intervertebral disc.

Some of the discs are made of metal, while others are a combination metal and plastic, similar to joint replacements in the knee and hip. Materials used include medical grade plastic (polyethylene) and medical grade cobalt chromium or titanium alloy.

Meet

Dr. Hamid Mir, M.D.

Dr Hamid Mir is a board certified orthopedic spine surgeon with fellowship training in combined neurosurgery and orthopedic spine surgery. He has offices in OC, Los Angeles & Riverside. Dr Mir specializes in spinal fusion, lumbar surgery and treating trauma as well as other conditions affecting the lumbar, thoracic, and cervical spine including degenerative diseases, stenosis, fracture, infection, adult scoliosis, revision, and complex reconstructions.

Testimonials

You are more than just a patient.

Dr. Hamid Mir is a member of American Board of Orthopedic Surgery with fellowship training in combined neurosurgical and orthopedic spine surgery at Cedars Sinai Medical Center in 2004. As a top rated spine surgeon, he specializes in cervical, thoracic, and lumbar spine diseases including degenerative, stenosis, fracture, infection, scoliosis, revision, and complex reconstructions.

Dr. Mir focused his practice on minimally invasive techniques. As Medical Director of DISC Sports & Spine Center, Dr. Mir is at the forefront of the field of minimally invasive spine surgery. The benefits of these techniques include less post-operative pain, quicker recovery reduced blood loss, less soft tissue damage, smaller surgical incisions, less scarring and improved function.

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