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.

    See Heat Therapy Cold Therapy

  • 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.

    See Rehabilitation After Spine Surgery

  • Back bracing may be prescribed for 4 to 6 weeks following surgery, in some cases. 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. 1 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.

    See Using a Back Brace for Lower Back Pain Relief

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.

See Practical Advice for Recovering from Back Surgery


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
  • Small bits of plastic or metal from the device breaking off into the surrounding tissue (wear debris), a rarely-reported phenomenon
  • Excessive pressure on spinal segments above or below the implanted disc, increasing the chance of disc or joint degeneration at an adjacent level

The risk of degeneration leading to adjacent segment disease is lower in artificial disc replacement when compared to spinal fusion surgery. However, the procedure cannot completely eliminate displaced pressure on adjacent segments.

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. 2 Formica M, Divano S, Cavagnaro L, et al. Lumbar total disc arthroplasty: outdated surgery or here to stay procedure? A systematic review of current literature. J Orthop Traumatol. 2017;18(3):197-215. Complication rates have been found to be higher when artificial discs or fusion devices are implanted at multiple spinal levels. 3 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)

See Spine Fusion Risks and Complications

Careful patient selection is crucial for minimizing complications following artificial disc replacement. 4 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 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.

See Specific Questions to Ask Your Spine Surgeon

Dr. Jack Zigler is an orthopedic surgeon at the Texas Back Institute and Co-Director of its Spine Fellowship Program. He has more than 30 years of experience performing spine surgery. He serves as the Co-Director of the Center for Disc Replacement at the Texas Back Institute and teaches around the work on surgical techniques for artificial disc replacement surgery.

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