Sometimes it is necessary to replace a damaged disk, in which case, an artificial disk may be used. Artificial disks are intended to offer a range of motion to patients who receive them.

The nature and severity of the patient’s pain indicates the type of artificial disk to use. In general, there are two types of disk replacement.

• Total disk replacement
• Disk nucleus replacement

The less severe the degeneration of the disk, the likelier that nucleus replacement may be considered, where available. In cases of pronounced degeneration, total disk replacement is more likely.

Total disk replacement

Artificial disks are typically made of either metal or plastic-like materials like biopolymers, or a combination of these materials.

The most commonly used designs use two plates: one attaches to the vertebrae above the disk being replaced, and the other to the vertebrae below it.

Who Is eligible for disk replacement?

Candidates for total disk arthroplasty have back pain that has not responded to other non-surgical treatments, and have clear symptoms of disk degeneration.

In a disk replacement, your surgeon accesses your spine through your abdomen (anterior approach). This may not be suitable for some patients, depending on their condition.

Other conditions that may prevent disk replacement include:

• Spondylolisthesis (disk slippage)
• Osteoporosis
• Allergy to artificial materials
• Spinal tumor
• Autoimmune disorders
• Pregnancy
• Chronic steroid use
• Previous abdominal surgery

Surgery is usually not considered for disk-related back pain unless the patient has been in severe pain for a prolonged period of time (at least six months), and non-surgical treatments and procedures have not been effective.

Total disk replacement offers an advantage over the more traditional spinal fusion in that patients usually return to their favorite activities more quickly.

Complications

Complications with total disk replacement are similar to those with spinal fusion. These may include:

• Nerve injury
• Damage to blood vessels
• Infection
• Wear and tear of artificial materials
• Breakage of the instrumentation
• Continued pain
• Sexual dysfunction
• Death

It is important to discuss your options thoroughly with your physician before considering spine surgery.