A short hospital stay (1 or 2 nights) following a lumbar artificial disc replacement procedure is typically required to monitor pain levels and supervise mobility. Standing and walking is usually required before leaving the hospital, and a cane or walker may be needed the first few days or weeks after surgery.
A combination of the following may be recommended or prescribed after leaving the hospital:
- Pain medications will likely be prescribed to manage postoperative pain. These medications can include recommendations for over-the-counter pain medications, as well as prescribed muscle relaxants and narcotic painkillers.
- Heat or ice therapy can also help reduce postoperative pain. Heat is usually recommended to help relax muscle tension and reduce muscle spasms that add to pain, and ice can be used to reduce inflammation that exacerbates pain.
- Physical therapy and activity is usually advised after spinal surgery to help strengthen the back. Exercise also maintains healthy circulation, providing nutrients and oxygen to the spinal structures as the back heals. A typical program consists of stretching, strengthening, and aerobic exercises targeted for the back. Aside from physical therapy, walking is a helpful post-operative activity. Walking can be done in a progressive fashion, starting with several short walks each day.
- Back brace. In some cases, a light back brace may be prescribed for 4 to 6 weeks following surgery. A back brace is typically recommended to limit motions that can cause damage to the spine as it heals, such as overextending the muscles or twisting the spine too far.5
Recovery from lumbar artificial disc replacement generally lasts 3 months while the spine adjusts to the implanted device and the body recovers from surgery. Recovery times can vary between patients.
Potential Risks and Complications of Artificial Disc Replacement
Complications associated with artificial disc replacement have been reduced in recent years as surgical methods and technologies have improved, and as indications for artificial disc replacement have been better identified.
Potential complications of artificial disc replacement may include:
- Failure of the device to reduce symptoms and/or recreate movement at the spinal segment
- Migration of the device forward or backward at the spinal segment
- Excessive pressure placed on spinal segments above or below the implanted disc (adjacent segment disease), increasing the chance of degeneration at an adjacent level’s disc or facet joints. While artificial disc replacement has reduced this complication compared to spinal fusion surgery, it cannot completely eliminate displaced pressure on adjacent segments.
- Small bits of plastic or metal from the device breaking off into the surrounding tissue (wear debris), a rarely-reported phenomenon
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In rare cases, complications following artificial disc replacement (infections or displacement) result in additional surgery to remove the device and fuse the joints, eliminating motion at the segment.
Similar rates of complications have been found between lumbar artificial disc replacement and lumbar fusion surgery.1 Complication rates have been found to be higher when artificial discs or fusion devices are implanted at multiple spinal levels.6
Careful patient selection is crucial for minimizing complications following artificial disc replacement.7 It is important to note that spine surgery, including artificial disc replacement, is only recommended in cases that are likely to benefit from surgery.
It is advised to talk with the operating surgeon for individualized recommendations. A second opinion from a surgeon with experience performing both fusion and disc replacement procedures may also be helpful in decision-making.
- Bible JE1, Biswas D, Whang PG, Simpson AK, Rechtine GR, Grauer JN. Postoperative bracing after spine surgery for degenerative conditions: a questionnaire study. Spine. 2009 Apr;9(4):309-16.
- Siepe CJ1, Mayer HM, Heinz-Leisenheimer M, Korge A. Total lumbar disc replacement: different results at different levels. Spine. 2007 Apr 1;32(7):782-90. (abstract)
- Park SJ1, Lee CS, Chung SS, Lee KH, Kim WS, Lee JY. Long-Term Outcomes Following Lumbar Total Disc Replacement Using ProDisc-II: Average 10-Year Follow-Up at a Single Institute. Spine. 2016 Jun;41(11):971-7