Arthroplasty (Artificial Disc Replacement)

What is an Artificial Disc Replacement?

Artificial disc replacement, also known as arthroplasty, is the replacement of a damaged spinal disc with an artificial (manufactured) disc.

An artificial disc is designed to support the vertebrae while still allowing backward and forward bending, side-to-side bending, and turning. Many artificial discs have been approved for use by the Food and Drug Administration (FDA). In general, they are composed of two endplates that move and slide on a central core. They are composed of metals like titanium or cobalt and sometimes a plastic such as polyethylene or polyurethane.

When is this Procedure Performed?

The vertebral column (backbone) is made up of 33 vertebrae. Between each set of vertebrae is a “cushion” called a disc. Age, genetics, and everyday wear and tear can contribute to disc damage and degeneration or herniation. Disc degeneration or herniation may cause pain, weakness, and numbness that radiate (spread) into the shoulders and arms.

Many patients with degenerated or herniated discs respond well to nonoperative treatment, such as physical therapy, injections, and neck braces. These measures are often effective in relieving symptoms, and they avoid the risks that come with any kind of surgery. However, if patients are experiencing severe neck and/or arm pain, and/or if nonoperative measures do not provide symptom relief, arthroplasty may be considered.

The best candidates for arthroplasty are younger patients who have a single disc herniation and normal spinal motion at the level of the disc. In some patients, replacement of more than one disc is possible. Older patients who have significant arthritis, bone spurs and limited mobility at the disc level are generally not good candidates for arthroplasty.

The neurosurgeons at The Spine Hospital at the Neurological Institute of New York are experienced in forming treatment plans that best suit individual patients and cases.

How is this Procedure Performed?

This procedure is performed under general anesthesia.

The surgeon makes an incision in the front of the neck and carefully exposes the front of the spine. X-ray imaging helps the surgeon verify the correct level of surgery.

Using an operating microscope, the surgeon removes the herniated or damaged disc, a procedure called a discectomy. An artificial disc of the appropriate size is then inserted into the disc space. Another X-ray confirms the positions of the plates. Then the surgeon closes the incision with sutures.

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