What Is Lumbar Disc Replacement?

• In simple terms: The damaged disc in the lower back is removed and replaced with an artificial disc, which relieves pressure on nerves and maintains motion.
  
  

• Scientifically: Lumbar disc arthroplasty involves anterior retroperitoneal exposure, complete discectomy, endplate preparation, and implantation of a prosthesis engineered to replicate lumbar biomechanics while preserving sagittal and coronal motion.
  
  

Conditions Treated

• Degenerative disc disease at a single lumbar level
  
  

• Chronic low back pain unresponsive to conservative treatments
  
  

• Radiculopathy caused by disc degeneration
  
  

• Disc collapse with loss of height but without instability
  
  

Who Is a Candidate?

Good candidates:

• Younger, active patients (typically under age 60)
  
  

• Single-level disc disease (usually L4–L5 or L5–S1)
  
  

• No severe arthritis or instability
  
  

• Healthy bone quality (no osteoporosis)
  
  

Not candidates if:

• Multi-level degeneration or instability requiring fusion
  
  

• Severe facet arthritis or deformity
  
  

• Prior fusion at adjacent levels
  
  

• Significant spondylolisthesis
  
  

The Lumbar Disc Replacement Procedure: Step by Step

Plain-English Overview

1. Anesthesia & positioning: You’re asleep under general anesthesia, lying on your back.
   
   

2. Incision: A small incision is made in the abdomen.
   
   

3. Disc removal: The diseased disc is removed completely.
   
   

4. Nerve decompression: Nerve roots and spinal canal freed from compression.
   
   

5. Artificial disc placement: A motion-preserving prosthesis is implanted between vertebrae.
   
   

6. Closure: Incision closed; patients often go home in 1–2 days.
   
   

Surgeon-Level Detail

• Approach: Anterior retroperitoneal exposure by spine surgeon with vascular access assistance.
  
  

• Discectomy: Annulotomy and full nucleus/annulus removal; PLL resected if compressive.
  
  

• Endplate preparation: Meticulous milling of endplates to match prosthesis; preserve cortical bone to prevent subsidence.
  
  

• Implantation: Artificial disc inserted under fluoroscopy; restores disc height and lordosis.
  
  

• Closure: Hemostasis secured; layered closure; drain rarely used.
  
  

Benefits of Lumbar Disc Replacement

• Maintains natural motion at treated level
  
  

• Reduces risk of adjacent segment disease compared to fusion
  
  

• Reliable relief of back and leg pain in properly selected patients
  
  

• Shorter recovery compared to lumbar fusion
  
  

• Preserves flexibility and function for active patients
  
  

Risks & Limitations

• Vascular or abdominal organ injury (due to anterior approach)
  
  

• Implant migration, loosening, or wear (rare with modern designs)
  
  

• Persistent back pain if pain source is not solely discogenic
  
  

• Not suitable for patients with severe arthritis or multi-level disease
  
  

• Long-term durability under study (20+ year results emerging)
  
  

Recovery Timeline

• Hospital stay: 1–2 days
  
  

• Weeks 1–2: Walking encouraged; light activity resumed quickly
  
  

• Weeks 2–6: Desk work possible; no heavy lifting or twisting
  
  

• 6–12 weeks: Begin structured physical therapy; flexibility and strength restored
  
  

• 3–6 months: Resume most activities, including light sports
  
  

• 6–12 months: Confirm long-term stability with imaging; unrestricted activity for most patients
  
  

Why Choose Desert Spine and Pain?

• Expert neurosurgeon: Dr. Greenwald has advanced training in both fusion and motion-preserving disc replacement
  
  

• MIS philosophy: Smaller incisions, faster recovery whenever possible
  
  

• Personalized care: Careful patient selection ensures best results
  
  

• Comprehensive approach: We provide both fusion and disc replacement options, always tailored to the patient
  
  

Frequently Asked Questions

How is lumbar disc replacement different from fusion?

Fusion locks vertebrae together, eliminating motion. Disc replacement relieves pain while keeping movement intact.

Who is the best candidate?

Younger, active patients with single-level disc disease and no instability are ideal.

How long do artificial discs last?

Most are designed for 10–20+ years. Studies show strong durability, though long-term data is still developing.

Is lumbar disc replacement safe?

Yes, when performed by an experienced neurosurgeon. Risks are mostly related to the anterior approach, which is done carefully with vascular assistance.

How does Desert Spine and Pain approach this surgery differently?

We combine neurosurgical precision, advanced implants, and minimally invasive exposures to maximize motion preservation and minimize recovery time.