Total Disc Arthroplasty & Total Disc Replacement
Degenerative Disc Disease is a common ailment that affects hundreds of people each year. This is not actually a disease, but a condition, where the discs in the spine degenerate. This can happen as a result of age, injury, or other conditions. Sometimes it is painless and causes very few problems, but in other cases it can be extremely painful. In these more extreme cases, if other treatments do not work, surgery becomes the best option. To fix a problem with a disc, many doctors turn to spinal fusion surgery, but there are also options for total disc arthroplasty and total disc replacement.
Disc Removal or Replacement Causes
Degenerative Disc Disease is a more generic term for the actual problems that warrant a disc replacement or removal. Sometimes discs herniate, which is when they bulge out of place, disrupting nearby nerves, muscles and vertebrae. Discs can also harden through losing their fluid. They can also tear or rupture, which also can cause problems with alignment of the spine. These are all causes for removal or replacement, as the disc creates strain and problems in other areas. There can be other underlying causes for why those discs are having problems, but those are the general reasons for needing a replacement or removal of a disc.
Fusion Vs Arthroplasty
When a patient is experiencing severe pain due to a diseased disc and no other options are available, fusion and arthroplasty are both great options for relieving that pain and regaining normal function. There are a few differences and main concerns or benefits that come with either surgery.
Spinal Fusion
A more common surgery used for disc disease is actually spinal fusion. In this operation, instead of replacing the disc, they remove it entirely. Then they fuse together the vertebrae that surround the disc by using a bone graft. This is then held in place with hardware. Generally the bone graft is taken from the patient or a deceased donor. Once the graft is in place, it heals and cements the other vertebrae together. This does work quite well, but may cause some limited mobility and takes a long time to heal. There are also issues that can develop if the spine does not heal properly around the graft or rejects it. This is currently considered the standard surgery for diseased discs, but it is becoming more outdated as better disc replacements have been developed.
Arthroplasty and Replacement
Total disc arthroplasty is the same as total disc replacement. Arthroplasty refers to a replacement of a joint, which in this case is being extended to a disc as it is technically a joint of the spine. In an arthroplasty, the disc itself is completely removed, then replaced with a medical grade silicone disc. There is also a base implanted that holds the disc in place which is made of metal. These together make up a replacement disc, which is inserted after the surgeon removes the diseased one. These surgeries have a great recovery rate and generally have less complications than a fusion surgery, however, they are more risky as there is nothing to brace that area. So if during recovery time, a patient were to fall or get injured in that area, it might slide out of place and cause some very serious problems. After it is healed, most patients are pain-free and can live as if they had not replaced the disc at all!
Which one is best?
When it comes to fusion vs arthroplasty, it truly comes down to the patient and their specific situation. For some people, losing their mobility is debilitating as they are athletes or have a livelihood that requires excessive movement. For these patients, fusion may not be the best option. For elderly people who do not need that, fusion may be a safer alternative as they have a higher risk of falling or complications. Whenever you are deciding which surgery should be performed, talk to your doctor! They can help you determine which surgery will be the most beneficial for you, and they will be able to give you the risks and benefits that may present in your body.
Total Disc Arthroplasty in different areas
Cervical
In the cervical spine, this surgery can be a bit more invasive. This surgery is done through an incision in the front of the neck, then the trachea and the surrounding tissues are pushed aside to reveal the injured disc. This is also done in fusion surgery, but it can cause problems swallowing or other adverse effects. This is also a different kind of implant, which is formed slightly differently to help the neck stay mobile and well-cushioned.
Lumbar
In the lumbar region of the spine, which is located in the lower back, disc replacement can be particularly beneficial because of its range of motion. The lumbar region is also a very painful area to have a diseased disc, so many patients find relief after surgery. Disc arthroplasty in the lumbar region does tend to have some more risks of the disc replacement slipping out of place, which is known as spondylolisthesis. If the patient is careful and weighs the risks, they may have the best results with arthroplasty.
Talk to your doctor
If you are experiencing symptoms consistent with degenerative disc disease, talk with your doctor. There are many other alternatives that might help you such as physical therapy, hot and cold compresses, or even steroid injections. These treatments might not work, but for many people they relieve pain and can help them function normally. Surgery should always be the last option except in only rare severe cases. Degenerative disc disease does not go away on its own! Talk to your doctor today about options that might work best for you. If surgery is determined to be the best course of action, consider the risks and benefits for yourself. As you take care of your body, you will be much happier in your life!
