Total disk replacement, also known as total disc arthoplasty, is an orthopedic procedure performed on the spine. Most commonly performed in the lumber, or lower back region and cervical or neck regions of the spine, total disc replacement is an increasingly popular spinal procedure that helps relieve pain, restore movement and mobility, and increases quality of life in spine care patients.
In recent years, total disc replacement is serving as a substitute for spinal fusion, a procedure often performed for individuals suffering pain and reduced mobility from joint degeneration processes. While spinal fusion has prove successful in many cases, progression of degenerative bone loss in nearby segments of the spine commonly occur. Completely replacing the disc in the affected area is a trend gaining popularity in the field, using a variety of prostheses or implants.
Total disk replacement, unlike other spine procedures, is utilized through an anterior or frontal approach, and also requires the services of a general or vascular surgeon to expose the spine from the front. This procedure is available and offers long-term solutions to individuals ranging from their 30s to their 50s and reduces the chance of surrounding or adjacent segment degeneration of the spinal column.
Cervical Disc Replacement - this procedure allows approach to the cervical or neck area of the spine through an incision in the front of the neck. This incision, approximately 1 inch long, exposes the spinal cord disc to be removed, after which an artificial disc replaces the damaged disc in the cervical spine. Hospitalization for this surgery is generally 24 to 48 hours and patients are able to move, though walking is discouraged for the first few hours following the surgery. Individuals are encouraged to return to normal activities after balance and coordination is restored.
Lumbar Spine Total Disc Replacement - lumbar spine total disk replacement is designed to restore full function and relieve pain, as well as maintain mechanical stability. A variety of artificial implants for discs are available, including those made of cobalt-chrome alloys, plasma sprayed titanium coatings, or ultra-high molecular weight polyethylene. Such implants are designed to maintain and improve range of motion, flexion and extension stability, rotation, lateral bending, and sustain compression.
Total lumbar disc replacement is similar to joint replacement of a hip or knee joint, totally removing the damaged joint and replacing it with plastic or metal implants. Lumbar spine total disc replacement is a complicated surgical procedure and, being relatively new, has not undergone long-term studies. Positive results in approximately 80% of patients in European studies were reported in Orthopedics Today (Vol 24, No 2, Feb 2004), more research is necessary before lumbar disc replacement becomes a standard option for degenerative disc disease processes in the U.S.
In the United States, a total disc replacement is extremely expensive, ranging on average between $75,000 to $110,000. In many cases, medical insurance does not cover all costs. Foreign locations such as those found in Western and Central Europe, Australia and South Korea may save patients approximately $40,000 in costs, including hospital stay. Individuals seeking disc replacement surgeries in Thailand may save even more, depending on the location and type of prosthesis or implant utilized.
Disc replacement surgical procedure is generally performed by an orthopedic surgeon specializing in spine care or neurosurgeon as well as a vascular or general surgeon. Surgeons should be chosen according to their expertise and experience in related fields. Physicians and surgeons should be certified in their field, and show membership in national or regional boards or associations in his or her country of origin.
Whenever possible, consumers are encouraged to get more than one opinion before engaging in any type of spinal surgery, as well as making sure that facilities, surgeons, and healthcare staff are accredited by international associations and organizations to ensure quality of equipment, technology, as well as quality of care by medical staff.
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