Lumbar disk replacement is a surgical procedure focused on the back or spine, where the vertebral bones that form the spine are arranged in a stacked manner. These vertebrae of the lumbar spine are separated by disks that function as cushions that allow smooth movement between them and prevent the bones collision with each other. The lower part of the spine which is known as lumbar spine sometimes has a degenerated or damaged disk and it is replaced with an artificial disk which is made up of either metal implants or plastic implants and sometimes the combination of both. Spine lumbar disc replacement surgery is performed as an alternative when the fusion of vertebrae is not desirable. Fusion is the joining of two vertebrae which allows greater stability but no movement. But in spinal lumbar disc replacement stability is compromised for the greater movements possible. People who have lower back pain and numbness of legs may undergo the lumbar disc replacement surgery. This surgery is beneficial in relieving pain but in severe cases it may be unable to totally eliminate the pain. Spine lumbar disc replacement treatments have so many risks as the poor skill or technique can lead to complete paralysis of the legs. So highly skilled professionals perform this surgery with proper care.
Types of Artificial Spine Lumbar Disc Replacement Treatment India
There are different techniques by which spine lumbar disc replacement can be performed. These are:
- Total disc replacement
- Prosthetic disc nucleus replacement
- Hybrid disc replacement
Total Disc Replacement (TDR)
The total disc replacement is the most common type of lumbar disc replacement surgery. It usually involves the removal of the damaged disc and replacing it with an artificial disc which is made up of metal or plastic. The artificial disc is designed according to the function of a natural disc which allows the movement and flexibility in the spine.
Prosthetic Disc Nucleus Replacement (PDNR)
In this technique, only the nucleus which is the inner gel-like portion of the disc, is replaced with a prosthetic device. The outer fibrous part of the disc is usually left as it is. This type of disc replacement helps to restore disc height and maintain stability and preserve the natural structure of the disc.
Hybrid Disc Replacement
A hybrid disc replacement combines elements of both fusion and disc replacement surgeries. In this procedure, one or more surrounding discs are replaced with artificial discs, while some of the discs are fused together. This approach is sometimes used when there are multiple levels of disc degeneration or when there are problems about spinal instability.
Procedure of Artificial Spine Lumbar Disc Replacement
The general view of the procedure is described as follow:
- Preoperative Evaluation: before the surgery, there is a need for thorough examination that includes a physical examination, medical history review, and tests such as X-rays, MRI scans, or CT scans. These tests help the surgeon to determine the location of the disc damage and the technique of surgery which should be applied.
- Anesthesia: The patient is placed under the effect of anesthesia to make them unconscious and free from pain during the procedure.
- Incision: The surgeon makes an incision in the lower back often in the midline to allow greater access to the affected lumbar disc.
- Disc Removal: The damaged disc is carefully removed which includes any part that may be pressing on the nerves present in surrounding and causing pain.
- Disc Replacement: An artificial disc is inserted into the empty disc space. The artificial disc is designed the same as the function of a natural disc which provides support and allows the movement of the spine and also allows the control of these movements.
- Closure: The incision is closed using sutures and a sterile dressing is applied to prevent the infection at the surgical site.
- Postoperative Care: Pain medications, blood thinners as well as instructions on mobility are provided to manage pain which helps in the recovery process. Physical therapy exercises are an essential part of the recovery process. They help in strengthening the surrounding muscles, and restore normal function of the spine.
Cost of Spine Lumbar Disc Replacement in India
The cost of Total Disc Replacement Surgery in India is significantly lower as compared to many other countries, including developed countries. On average, the price range for Total Disc Replacement Surgery in India is approximately 3,500 USD to 6,500 USD. However, the cost may be different in different cities of India.
Cost of spine lumbar disc replacement in different cities of India:
New Delhi : 5220 USD - 6180 USD
Mumbai 5400 USD 6300 USD
Chennai : 5700 USD - 6600 USD
Bangalore : 5520 USD - 6360 USD
Hyderabad : 5880 USD - 6780 USD
Ahmedabad : 6000 USD - 6900 USD
Nagpur : 5100 USD - 6000 USD
Pune : 5400 USD - 6300 USD
Symptoms and Risk factors
Here are some common indications for lumbar disc replacement:
- Chronic DiscoGenic Low Back Pain
- Failed Non-Surgical Treatment
- Lumbar Disc Degeneration
- Herniated Lumbar Disc
- Discogenic Radiculopathy
- Lack of Spinal Stability
- Preservation of Spinal Motion
- Younger Age (typically under 60 years old)
- Absence of Severe Spinal Deformities
- Absence of Significance Facet Joint Disease
Risk Factors of Spine Lumbar Disc Replacement
Spine lumbar disc replacement have some risk factors which are:
Infection
There is a risk of developing an infection at the site of surgery. There is a need to take some precautions that can minimize this risk, such as sterile techniques during surgery and medications for infection. However, in some rare cases, infection spreads despite all the prevention treatment.
Bleeding
There is a risk of bleeding during and after the procedure. In some cases, bleeding may occur and the transfusion is required.
Nerve or Spinal Cord Damage
There is a risk of injury to nerves in the surrounding or the spinal cord during the procedure. This can lead to weakness, numbness, or even paralysis of the lower legs.
Allergic Reactions
Some individuals may have allergic reactions to materials used in the artificial disc or surgical implants.
Artificial discs, like any medical implants, can have device-related complications. These may include dislocation, tear, fracture, or failure of the implant which further require an additional surgery.
Blood Clots
Prolonged immobility during and after surgery can increase the risk of blood clots in the legs or lungs. Early mobility, and blood-thinning medications are used to prevent the blood clot formation.
