Artificial Disc Replacement
Artificial disc replacement (ADR) is a type of spinal disc surgical procedure that utilizes an anterior (front - through the abdominal region) approach to replace a painful, damaged, arthritic, worn-out intervertebral disc of the lumbar spine with a metal and plastic prosthesis (artificial disc). Artificial disc replacement is often recommended after other nonsurgical methods such as medication, physical therapy, and exercise have failed to produce desired results.
Artificial disc replacement is suitable for patients with isolated 1-level (one disc only) degenerative disc disease. Prior to the development of ADR, spinal fusion was the principal treatment for painful degenerative disc disease that failed to improve with nonoperative management. ADR is generally not recommended for patients with spinal fractures, instability, neurologic compression, or multiple level degenerative disc disease - spinal fusion remains the treatment of choice for these conditions.
Artificial disc replacement surgery takes place under a general anesthesia. The procedure takes between one and two hours, followed by a three to four-day hospital stay. The artificial disc is designed as two metal end plates, between which may be found medical grade polyethylene or plastic or gel-like substances, much like a sandwich.
One of the most common procedures for artificial disc replacement surgery is minimally invasive procedure utilizing a small incision (3 to 8 cm) beneath the belly button. Internal organs and blood vessels are gently moved out of the way to provide a view of the spinal column from the front (anterior view).
Through the small incision, a neurosurgeon or orthopedics spine surgeon inserts a special grasping instrument that removes the damaged vertebral disc. An end plate, often with small metal teeth attached, is fastened to the upper and lower portion of the vertebral space. Bone eventually absorbs and grows around these metal plates, offering stability, longevity, and strength. Artificial disc prosthesis, usually made of a gelatinous or plastic substance, is inserted into the vertebral space to approximate the normal height of the original disc.
Most patients are usually able to go home 2-4 days after Artificial disc replacement (ADR) surgery. Before patients go home, physical therapists and occupational therapists work with patients and instruct them on proper techniques of getting in and out of bed and walking independently. The patient is often required to wear a back brace support for up to 12 weeks following such a surgical procedure to enable and encourage healing.
The advantages of Artificial disc replacement (ADR) include a faster recovery time than spinal fusion and preserved motion at the disc level.
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