Lumbar and cervical disk replacement procedures are surgical procedures focused on the back or spine, where the vertebral bones that form the neck and lower back spine are arranged in a stacked manner. These vertebrae of the lumbar and cervical spine are separated by disks that function as cushions that allow smooth movement between them and prevent the bones from colliding with each other. The lower part of the spine is known as the lumbar spine and the spine in the neck region is known as the cervical spine. Sometimes the spine has a degenerated or damaged disk and it is replaced with an artificial disc which is made up of either metal implants or plastic implants and sometimes a combination of both. Spine lumbar and cervical disc replacement surgery is performed as an alternative when the fusion of vertebrae is not suitable according to the condition of the patient. Fusion is the joining of two vertebrae which allows greater stability but no movement. However, in spinal lumbar and cervical disc replacement, stability is compromised for the greater movements possible. People who have lower back pain and pain in the neck region along with the feeling of numbness in legs and arms may undergo lumbar and cervical disc replacement surgery. This surgery is beneficial in relieving pain but in severe cases, it may be unable to eliminate the pain. Spine lumbar and cervical disc replacement treatment have so many risks as poor skill or technique can lead to complete paralysis of the legs or arms.
Types of Lumbar And Cervical Disc Replacement Treatment India
There are different techniques for spine lumbar and cervical disc replacement. These are:
- Total disc replacement
- Prosthetic disc nucleus replacement
- Hybrid disc replacement
Total Disc Replacement (TDR)
Total disc replacement is the most common type of disc replacement surgery for cervical and lumbar spine. 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 movement and flexibility in the cervical and lumbar 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 maintain stability and preserve the natural structure of the cervical and lumbar spine 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 of the cervical and lumbar spine are replaced with artificial discs, while some of the discs are fused. This approach is sometimes used when there are multiple levels of disc degeneration or when there are problems with spinal instability in the neck and lower back regions.
Procedure of lumbar and cervical disc replacement
The general view of the procedure is described as follows:
- Preoperative Evaluation: before the surgery, there is a need for a 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 in the neck and lower back region.
- 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 and neck region often in the midline to allow greater access to the affected disc in the lumbar and cervical region.
- Disc Removal: The damaged disc in the neck and lower back is carefully removed which includes any part that may be pressing on the nerves present in the surrounding area and causing pain.
- Disc Replacement: An artificial disc is inserted into the empty disc spaces in the lumbar and cervical regions. 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 and 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 strengthen the surrounding muscles and restore the normal function of the spine.
Cost of Lumbar and Cervical 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 ₹ 2,90,000 to ₹ 5,40,000. However, the cost may be different in different cities of India.
Lumbar and cervical disc replacement : ₹ 3,00,000 - ₹ 5,20,000
Symptoms & Risk Factors of Lumbar and Cervical Disc Treatment
Here are some common indications for lumbar and cervical disc replacement:
- Chronic DiscoGenic Low Back and Neck Pain
- Failed Non-Surgical Treatment
- Lumbar and cervical Disc Degeneration
- Herniated Lumbar and cervical Disc
- Discogenic Radiculopathy
- Lack of Spinal Stability in the neck region and back
- 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 has 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, the infection spreads despite all the preventive treatments.
Bleeding
There is a risk of bleeding during and after the procedure. In some cases, bleeding may occur and a 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 implant, can have device-related complications. These may include dislocation, tear, fracture, or failure of the implant which further requires 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 blood clot formation.
06/27/2024
