Disc injuries, such as herniation and degeneration, are common causes of low back pain and one of the main reasons for seeking medical attention. Artificial disc replacement (ADR) offers an effective alternative to spinal fusion, relieving pain without limiting the natural mobility of the spine. In this article, we explain what this technique involves, who can benefit from it, and what the recovery process is like.
What is ADR surgery?
ADR (Artificial Disc Replacement) surgery is a procedure in which a damaged spinal disc is replaced by a prosthesis that mimics the movement and function of a healthy, natural disc. It can be an effective cure for back pain caused by a herniated disc.
How can I find out if I am a candidate for this surgery?
To determine if a patient is likely to benefit from ADR surgery, it is necessary to have a thorough medical history, a complete physical exam, and imaging tests, such as magnetic resonance imaging (MRI), computed tomography (CT), and X-rays of the spine.
At Instituto Clavel, we have an EOS device, which uses technology that can provide a whole body image with greater detail than conventional X-rays, while exposing the patient to less radiation. These whole body images are very useful for evaluating the shape of the entire spine and to assess how many degrees of lordosis (lumbar curvature) are appropriate for each patient.
In which cases is ADR recommended?
We always recommend first trying conservative treatment options for pain relief, such as medication, rehabilitation/physical therapy, and in some cases, epidural injections or rhizolysis. When conservative treatments are not successful, ADR surgery may be an option for patients with:
- Chronic low back pain that does not improve with conservative treatment
- Low back pain that persists after herniated disc surgery
- Radiculopathy (nerve pain) or compression of nerve roots due to a recurrent disc herniation
In cases of chronic low back pain, ADR is especially indicated for patients who are under 50 years old and without abdominal obesity, as these patients are likely to have better results with fewer risks.
What does the procedure involve?
At Instituto Clavel, we are experts in performing this surgery on the lumbar spine with the anterior approach technique. One of the advantages of this minimally invasive technique is that it requires less manipulation of soft tissues, which leads to faster postoperative recovery for the patient.
The operation is performed under general anesthesia. The surgeon makes an incision below the navel to access the spine from the front, carefully moving aside the abdominal structures and blood vessels (iliac arteries and veins), and then the damaged disc, or disc hernia is removed. Next, the surgeon inserts the prosthetic disc. Finally, the muscular fascia and skin are closed.
What is the recovery process like?
- After the operation, the patient usually spends a few hours in the recovery room for monitoring, and then is taken to their hospital room. The total hospital stay is about 3- 4 days.
- The patient will be up and walking from the first day, with the help of a lumbar support belt. This support may be used as follows:
- First month after surgery: all day, only removed for sleeping.
- Second month: only for standing
- Third month: usually no longer needed.
- Some postoperative constipation is common, so laxatives are prescribed.
- If leg pain appears following surgery, it can be treated with a short course of corticosteroids (dexamethasone) and medications for neuropathic pain such as gabapentin or pregabalin.
- During the first month after surgery, the patient can begin rehabilitative physical therapy if there is remaining back pain, and beginning in the second month, the patient can begin doing some light physical activity and exercise.
- Full recovery can take between 3 to 6 months, although patients are usually able to perform their normal daily activities and go back to work sooner than that.
What are the advantages of ADR over other surgeries?
Unlike other spine surgery, such as arthrodesis or spinal fusion, ADR allows the natural movement of the spine to be preserved, so the patient can recover a more active life. In addition, this procedure has been validated by over 20 years of clinical experience, including follow-up studies since 2004.
Can ADR also be used for cervical vertebrae?
Yes, ADR can be used in both the lumbar spine and the cervical spine, where it has shown excellent results in selected cases.
At Instituto Clavel, we have more than 20 years of experience and have performed more than 2,500 artificial disc replacement (ADR) surgeries. This track record allows us to offer a safe, minimally invasive procedure tailored to each patient, with the best results in terms of recovery and quality of life.
Do you suffer from persistent lower back or neck pain?
Request a personalized assessment with our specialists and find out if ADR surgery could be the solution you need.
Dr. Pablo Barbero
Neurosurgeon
Categories: Spine treatments, Surgery, Back pain