OVERVIEW

OVERVIEW

Lumbar disc replacement, also known as lumbar artificial disc replacement, is a motion-preserving surgical procedure designed to treat chronic low back pain caused by degenerative disc disease. The procedure involves removing a damaged lumbar intervertebral disc and replacing it with an artificial disc implant that is engineered to restore disc height, maintain spinal alignment, and preserve natural motion at the treated level.

Unlike spinal fusion—which permanently eliminates motion—lumbar disc replacement is designed to relieve pain while allowing the spine to continue moving naturally. In carefully selected patients, this approach can reduce pain, improve function, and potentially decrease stress on adjacent spinal levels.

BACKGROUND

Degenerative disc disease of the lumbar spine is a common source of chronic low back pain. Over time, intervertebral discs can lose height, hydration, and structural integrity, leading to pain, stiffness, and sometimes nerve irritation.

Historically, lumbar fusion has been the standard surgical option when non-operative treatments fail. While effective for pain relief in many patients, fusion alters spinal biomechanics by eliminating motion at the treated segment, which may increase stress on adjacent levels over time.

Lumbar disc replacement was developed as an alternative for select patients, with the goal of:

Removing the pain-generating disc

Preserving normal spinal motion

Maintaining disc height and alignment

Potentially reducing adjacent-level degeneration

Advances in implant design and surgical technique have improved outcomes, making lumbar disc replacement an effective option for properly selected candidates.

IDEAL CANDIDATES

Lumbar disc replacement is not for everyone. Ideal candidates are carefully selected based on clinical symptoms, imaging findings, and overall spinal health.

Patients who may be good candidates typically:

• Chronic low back pain primarily originating from one (occasionally two) lumbar disc levels
• Symptoms that persist despite 6-12 weeks of conservative treatment (NSAIDS, PT, Injections)
• Minimal or no facet joint arthritis
• No spinal malalignment
• No spinal instability
• Good bone quality (no history of osteoporosis)
• Are otherwise healthy and able to tolerate surgery

Patients who are generally not ideal candidates include those with:

• Significant facet joint degeneration
• Multilevel lumbar degenerative disease
• Spinal instability (e.g., high-grade spondylolisthesis)
• Severe scoliosis or deformity
• Active infection, fracture, or severe osteoporosis
• Prior extensive lumbar surgery that alters anatomy or stability

Proper patient selection is critical to achieving optimal outcomes and long-term success with lumbar disc replacement. Dr. Brandon A. Ortega, in Torrance and Long Beach, California, helps his patients understand the cause of their back pain and explores all available treatment options, which are tailored to their specific needs and goals. Contact his office, Brandon A. Ortega, MD, to see if you are a candidate for a lumbar disc replacement (LDR).