In some cases, disc replacement surgery in both cervical and lumbar spines is a viable alternative to fusion surgery or continued unsatisfactory conservative management.
Surgeons at the Tasmanian Spine Service have extensive experience in both cervical and lumbar disc replacement surgery.
A number of practical lumbar disc replacement devices have undergone clinical trials and certification, the latest designs being the most advanced, with biomechanic characteristics that closely mimic the qualities of a native disc.
Disc arthroplasty is indicated for patients suffering from discogenic pain, who do not have facet joint disease or osteoporosis, and who do not have any anatomical or medical contra-indications to an anterior approach to the lumbar spine. It may also be considered in patients who have multiple recurrent disc herniations from a single level, or who have a massive central disc protrusion.
After surgery, most patients are discharged home on the third or fourth post-operative day.
There is a structured follow up process, with appointments at six weeks, three months, six months and one year. Thereafter, it is recommended that follow up occur every two years.
The biomechanic testing of these devices in vitro (that is, in an environment that seeks to replicate the conditions inside the human body, artificially) suggest an expected lifespan of at least thirty years. Clinical use of these devices has not exceeded 12 years for most prostheses.
Cervical disc arthroplasty has a shorter history than lumbar disc arthroplasty, but has proven to be a highly effective alternative to anterior cervical fusion surgery, and is considered in some centres to have overtaken fusion as the standard of care, in appropriate cases.
Disc replacement techniques are not suitable for use when the operated level is unstable, when there is significant facet joint disease, or in the presence of infection, or osteoporosis.