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M O T I O N P R E S E R V A T I O N · L U M B A R S P I N E
Lumbar Disc Replacement
A motion-preserving surgical procedure that removes a damaged lumbar disc and replaces it with an artificial prosthesis, eliminating discogenic pain, restoring disc height, and maintaining the lumbar spine's natural flexibility.
> 90%
report significant pain reduction
< 1-2
nights average hospital stay
< 6-12 Wks
average return to full activity
O V E R V I E W
What is Lumbar Disc Replacement?
Lumbar disc replacement (LDR) treats degenerative disc disease in the lower back by removing the diseased disc through an anterior (abdominal) approach and replacing it with a precisely sized prosthetic device. When a lumbar disc collapses, the resulting loss of disc height and abnormal segmental motion can compress nerves and produce chronic low back pain and leg pain (sciatica). LDR addresses this directly at the source.
Unlike lumbar fusion, LDR maintains segmental mobility, the lumbar spine continues to bend, extend, and rotate through the treated level rather than transferring all motion to adjacent segments. This distinction has meaningful long-term implications for adjacent disc health and functional quality of life.
𝐖𝐇𝐎 𝐈𝐒 𝐂𝐀𝐍𝐃𝐈𝐃𝐀𝐓𝐄?
Patients with one- or two-level lumbar DDD with predominantly axial low back pain who have failed at least 6 weeks of conservative treatment.
𝐋𝐄𝐕𝐄𝐋𝐒 𝐓𝐑𝐄𝐀𝐓𝐄𝐃
Most commonly L4–L5 and L5–S1, the segments that bear the greatest mechanical load in the lumbar spine.
𝐓𝐇𝐄 𝐀𝐏𝐏𝐑𝐎𝐀𝐂𝐇
Performed through a retroperitoneal anterior approach with a vascular access surgeon, allowing direct disc access without disturbing posterior muscles or neural structures.
𝐅𝐃𝐀 - 𝐀𝐏𝐏𝐑𝐎𝐕𝐄𝐃
The ProDisc-L devices carry FDA approval with robust IDE trial data demonstrating non-inferiority and superiority to fusion in select populations.
B E N E F I T S
What is Lumbar Disc Replacement?
For appropriately selected patients, LDR delivers equivalent or superior pain relief compared to fusion while protecting the long-term integrity of the lumbar spine. The benefits are most pronounced for active patients with isolated disc disease at one or two levels.
𝐌𝐀𝐈𝐍𝐓𝐀𝐈𝐍𝐄𝐃 𝐋𝐔𝐌𝐁𝐀𝐑 𝐌𝐎𝐁𝐈𝐋𝐈𝐓𝐘
Patients retain bending and rotation at the treated level, supporting more natural movement in daily activity, exercise, and sport.
𝐀𝐃𝐉𝐀𝐂𝐄𝐍𝐓 𝐃𝐈𝐒𝐂 𝐏𝐑𝐎𝐓𝐄𝐂𝐓𝐈𝐎𝐍
Fusion concentrates stress at the levels above and below. LDR distributes load more physiologically, reducing adjacent disc degeneration over time.
𝐍𝐎 𝐏𝐎𝐒𝐓𝐄𝐑𝐈𝐎𝐑 𝐈𝐍𝐒𝐓𝐑𝐔𝐌𝐄𝐍𝐓𝐀𝐓𝐈𝐎𝐍
LDR avoids pedicle screws and rods of posterior fusion, reducing hardware complications and preserving future surgical options if ever needed.
𝐄𝐐𝐔𝐈𝐕𝐀𝐋𝐄𝐍𝐓 𝐎𝐑 𝐒𝐔𝐏𝐄𝐑𝐈𝐎𝐑 𝐎𝐔𝐓𝐂𝐎𝐌𝐄𝐒
FDA IDE trial data at 5-7 years shows LDR provides equivalent or superior results in pain, function, and satisfaction compared to ALIF fusion.
𝐋𝐎𝐖𝐄𝐑 𝐑𝐄𝐎𝐏𝐄𝐑𝐀𝐓𝐈𝐎𝐍 𝐑𝐀𝐓𝐄𝐒
By avoiding fusion complications like pseudarthrosis and adjacent segment disease, LDR patients have lower reoperation rates at 5–10 years.
𝐈𝐌𝐏𝐑𝐎𝐕𝐄𝐃 𝐐𝐔𝐀𝐋𝐈𝐓𝐘 𝐎𝐅 𝐋𝐈𝐅𝐄
Patients consistently report higher satisfaction with physical function and ability to return to recreational and occupational activities compared to lumbar fusion cohorts.
L D R V S F U S I O N
Lumbar disc replacement vs ALIF
LDR and anterior lumbar interbody fusion (ALIF) both approach the spine from the front and address the diseased disc. The difference lies in what follows, motion or stillness, and what that means for the rest of your spine over time.
D r . O r t e g a ’ s P r e f e r e n c e f o rE l i g i b l e P a t i e n t s
Lumbar Disc Replacement (LDR)
✓ Preserves motion at L4–L5 or L5–S1
✓ No bone graft -> no pseudarthrosis risk
✓ Lower adjacent segment disease burden
✓ No posterior hardware required
✓ Lower long-term reoperation rates
– Requires intact posterior elements (facets)
– Not indicated in spondylolisthesis/deformity
Anterior Lumbar Interbody Fusion (ALIF)
✓ Addresses spondylolisthesis and instability
✓ Strong deformity correction capability
✓ Applicable across a broader pathology
– Permanently eliminates motion
– Higher adjacent disc degeneration risk
– Often requires posterior instrumentation
– Longer recovery due to fusion consolidation
Not every patient qualifies for LDR. Patients with significant facet arthritis, spondylolisthesis, prior posterior fusion, or osteoporosis are often better served by fusion. Dr. Ortega's evaluation includes standing X-rays, MRI, and CT scanning to determine the approach most likely to produce the best long-term outcome for your specific anatomy and pathology.
R E C O V E R Y
What to Expect After Lumbar Disc Replacement
LDR recovery follows a structured progression. Because there is no bone fusion to wait for, milestones are determined by anterior incision healing, soft tissue recovery, and the gradual return to loading the lumbar spine. Most patients are pleased by how quickly their leg pain and back pain begin to resolve.
| Day of Surgery | Hospital Admission, < 1-2 Nights LDR is performed through a retroperitoneal anterior incision with an access surgeon. A short hospital stay of 1-2 nights is typical while early mobilization begins. |
|---|---|
| 1-2 Weeks | Early Mobilization at Home |
| 3-6 Weeks | Expanding Activity |
| 8–12 Weeks | Return to Rull Activity |
| Long Term | Motion Maintained, Adjacent Spine Protected |
Ready to Find Out if Lumbar Disc Replacement is Right for You?
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