Low back · Motion-preserving surgery
Lumbar disc replacement
Replaces a worn disc in the low back with an artificial disc. It can ease back pain from a damaged disc while keeping that part of the spine moving.
What is lumbar disc replacement?
Your low back, or lumbar spine, has five large bones with a disc between each pair. When a disc wears down, it can become a source of ongoing back pain.
In a lumbar disc replacement, also called lumbar arthroplasty, the worn disc is removed and an artificial disc takes its place. It restores the height of the disc space and lets that level keep bending and twisting.
It can treat
How does it compare with a fusion?
Your back keeps moving
The treated level can still bend and twist. A fusion joins the bones together so that level no longer moves.
Less bone work
Only the damaged disc is removed. No bone graft is needed to make bones grow together.
No waiting for bone to heal
There is no fusion that has to grow solid, so many people return to daily activities sooner.
Less strain on nearby discs
Studies suggest it may lower the chance of needing surgery at the levels next to it, compared with fusion.
Fusion is still the right operation for some problems, such as an unstable spine or a large curve. Dr. Wey recommends whichever one fits your spine.
Am I a candidate?
These are general guides. Dr. Wey decides with you after an exam, a review of your history, and a careful look at your imaging.
Often a good fit
- Back pain coming mainly from one or two worn discs, usually at L3-L4, L4-L5, or L5-S1
- Pain mostly in the low back, sometimes with some leg pain
- At least six months of non-surgical care, such as physical therapy, medicines, or injections, without enough relief
- Generally good health and good bone strength
Usually not the right choice
- Weak bones (osteoporosis)
- More than a mild slip, or an unstable spine
- Advanced arthritis in the small joints at the back of the spine
- A significant curve or deformity
- Past abdominal surgery that makes the front approach unsafe
- Active infection, or certain metal allergies
If disc replacement is not right for you, other options can still help.
What to expect
1Before surgery
- A full visit: your history, an exam, and a review of your MRI, X-rays, or CT scan.
- If disc replacement fits, you get clear instructions to prepare, such as which medicines to pause and when to stop eating.
- Some patients also meet the access surgeon who helps with the approach.
2During surgery
- You are fully asleep under general anesthesia.
- An access surgeon makes a small cut in the lower belly and gently moves the organs and blood vessels aside.
- Dr. Wey removes the worn disc and prepares the space.
- He places the prodisc L implant, with two metal endplates and a plastic core, and confirms its position with live X-ray.
- The cut is closed and covered with a dressing.
3After surgery
- Most people stay in the hospital one or two nights.
- Walking begins the same day or the next day.
- Physical therapy helps rebuild strength and flexibility.
- Desk work often resumes in two to four weeks. Heavy lifting and twisting wait about six weeks.
- Follow-up visits and X-rays check your progress.
Dr. Wey goes over the details of your own recovery in person.
The implant: prodisc® L
Dr. Wey uses the prodisc L artificial disc, made by Centinel Spine. It uses a ball-and-socket design, two metal endplates with a plastic core, that lets the treated level move in a controlled way.
- FDA-approved for one or two levels, from L3 to S1.
- Centinel Spine reports it is the only artificial disc in the U.S. approved for two levels in the low back.
- The prodisc design has been in use since 1990. Centinel Spine reports more than 300,000 implants worldwide and more than 590 published papers.
prodisc® is a registered trademark of Centinel Spine, LLC.
Find out if this is right for you
Bring your MRI and X-rays to your first visit. Office (201) 836-1663