Disc replacement surgery, also known as disc arthroplasty, is a procedure that replaces damaged or worn out discs in the spine. It is considered a major surgery and done to relieve neck or back pain caused by degenerative disc disease or disc herniations. Let’s look at some frequently asked questions to understand if disc replacement is classified as major surgery.
Is disc replacement surgery invasive?
Yes, disc replacement surgery is invasive and involves making an incision to access the damaged disc. The surgeon removes the damaged disc and inserts an artificial disc prosthesis in its place. It requires entering the space between two vertebrae, cutting into the disc, and removing it before inserting the artificial disc implant. Hence, it is considered an invasive procedure.
How long does disc replacement surgery take?
A typical disc replacement surgery takes 1-3 hours depending on the number of levels being treated. A single level disc replacement like C5-C6 or L4-L5 may take 1-2 hours. A two level disc replacement like C5-C7 may take 2-3 hours. The surgery time also depends on factors like the surgeon’s experience and the complexity of the case.
What kind of anesthesia is used?
Disc replacement surgery is done under general anesthesia. This means you are fully asleep and unconscious during the procedure. General anesthesia is essential to ensure you do not feel any pain or discomfort during the surgery. It also allows the surgeon to access the spine without movement or resistance from the patient.
How long is the recovery time?
The recovery time after disc replacement surgery varies from person to person but is generally between 6-12 weeks. Here is a general timeline of the recovery process:
- First 2 weeks – Rest and limited mobility with assistance required for activities
- 2-6 weeks – Gradually increase mobility and perform light activities
- 6-12 weeks – Continue physical therapy, build endurance and strength
- 3-6 months – Resume normal activities and exercise with restrictions
- 1 year – Complete recovery anticipated in most cases
So while some patients may recover quicker, it takes around 3-6 months for most people to resume normal activities after disc replacement surgery. The recovery is gradual with activity restrictions in the initial months.
How long is the hospital stay?
The typical hospital stay after disc replacement surgery is 1-3 days. Patients are monitored closely for the first 24 hours after surgery in a hospital room. If there are no complications, patients can be discharged home after 1-2 days. However, the hospital stay may be longer if there are complications or slower recovery. With minimally invasive techniques, some patients can even go home the same day.
What are the risks and complications?
As with any major surgery, disc replacement surgery also carries certain risks and possible complications such as:
- Infection
- Bleeding
- Nerve damage
- Paralysis
- Blood clots
- Implant failure
- Adjacent segment disease
However, serious complications are not very common with disc replacement surgery. The overall complication rate is estimated to be around 5-10%. Choosing an experienced surgeon and following post-op precautions can help minimize risks.
What are the long term results?
Clinical studies show that disc replacement has good long term results in properly selected patients. Here are some key findings on the long term outcomes:
- Significant pain relief is maintained over time – About 80-90% of patients experience sustained back/neck pain relief at 5-10 year follow-ups.
- Improved function – Patients report better ability to perform daily activities compared to pre-surgery.
- High patient satisfaction – Over 90% patients are satisfied with the results of disc replacement at 7-10 years.
- Low rates of reoperation – Less than 10% patients require additional surgery at the operated segment at 10 years.
So for patients who are ideal candidates, disc replacement provides excellent long term results in terms of pain relief, improved function and quality of life.
How long does the artificial disc last?
The artificial discs used in replacement surgery are made of durable materials like metal and plastic. Data from long term clinical studies indicates that these artificial discs have a durability of over 15-20 years in most patients. Some even last 25-30 years with minimal wear. Modern discs use superior biomaterials and designs to ensure longevity. However, factors like excessive physical activity may affect longevity in some cases.
Is the surgery minimally invasive?
Some surgeons are now performing disc replacements through smaller incisions using minimally invasive techniques. These involve using an endoscope or microscopy for visualization. Smaller incisions result in less blood loss, reduced scarring, shorter hospital stay and faster recovery. However, the surgery still requires entering the spine and removal of disc material. So disc replacement cannot be considered a completely non-invasive procedure even with minimally invasive methods. The spine surgery still needs to be performed meticulously.
Can it be done as an outpatient procedure?
In some cases, disc replacement surgery is being done as an outpatient procedure. Candidates for outpatient surgery are usually young, healthy and active individuals undergoing single level disc replacement. They are discharged on the same day of surgery after a few hours of post-op monitoring. However, outpatient disc surgery is still not very common as most surgeons prefer to monitor patients overnight after such an invasive procedure. A short hospital stay allows managing any postoperative complications better.
How is the recovery for an outpatient procedure?
Patients undergoing outpatient disc replacement can recover relatively faster. Here is the general recovery timeline:
- First week – Very limited activity with assistance at home
- 2-4 weeks – Gradually increase light mobility and activities
- 4-8 weeks – Continue physical therapy and strength building
- 2-3 months – Resume deskwork and regular activities
- 6 months – Most patients can resume normal activities
So while recovery may be slightly faster after outpatient surgery, activity restrictions and rehabilitation are still needed for 2-3 months. Guidance from the surgeon is essential to avoid complications.
When can I return to work?
The return to work timeframe after disc replacement depends on the nature of work and recovery progress:
- Desk jobs – May return in 4-6 weeks
- Light manual labor – 8-12 weeks
- Heavy lifting jobs – Minimum 3-4 months
Patients with deskjobs and ability to work from home can return in 1-2 months. Physically demanding jobs will require 3-4 months before full duties can be resumed. Your surgeon will evaluate spine healing before clearing return to work. Restrictions may be needed initially when going back to work.
When can I start exercising after surgery?
Post-surgery exercise guidelines are:
- First 6 weeks – Avoid any exercise apart from short walks
- 6-12 weeks – Begin physiotherapy focused on mobility and core strength
- 3-6 months – Start light cardiovascular exercise like cycling and swimming
- 6-9 months – Strength training can be resumed gradually
- 9-12 months – Normal exercise routine may be resumed
Activities like bending, lifting and twisting should be avoided initially. Low impact cardio and core strengthening exercises are recommended after 3 months before restarting regular workouts.
Will I need pain medications long term?
Most patients are able to wean off prescription pain medications within 6-12 weeks after disc replacement surgery. Mild over-the-counter medications may be used sparingly beyond this period. Only a small percentage of patients continue requiring strong opioid medications long term. Your surgeon will provide a pain management protocol to transition off prescription drugs. Long term pain medication use is generally not anticipated if disc replacement surgery outcomes are good.
Conclusion
In summary, disc replacement does qualify as a major surgery as it involves entering the spine, removing the damaged disc and inserting an artificial prosthesis. It has risks of complications like any major procedure and requires extensive recovery and rehabilitation. However, with a skilled surgeon, appropriate patient selection and good postoperative care, disc replacement surgery can provide lasting pain relief and improve function in patients with severely degenerative discs not responding to more conservative treatments. If you are considering disc replacement surgery, discuss the pros and cons thoroughly with your spine specialist.