At New Delhi Spine we have more than 20 years of experience in artificial disc replacement (ADR) surgeries. The high success rate of this minimally invasive technique allows our patients to increase their quality of life.
Artificial disc replacement or ADR surgery is a surgical procedure in which a degenerated intervertebral disc is removed and replaced with an artificial implant that mimics the function of a natural healthy spinal disc. This surgical treatment is used for patients suffering from chronic back pain or neck pain due to cervical or lumbar degenerative disc disease, who have not found relief through conservative treatments.
At New Delhi Spine, we are pioneers in artificial disc replacement surgery, using the minimally invasive technique of anterior approach to the spine for the placement of the artificial disc. Thanks to this minimally invasive technique, we are able to avoid opening the back muscles, which in turn reduces postoperative pain and helps patients have shorter recovery periods and better results.
At New Delhi Spine we are experts in spine surgery, having more than 20 years of experience, having performed more than 6000 Lumbar disc replacements and 3000 cervical disc replacements. This experience ensures that we can perform this minimally invasive operation safely and obtain the best results for our patients.
We have found that this surgical treatment is effective in significantly reducing pain in 95% of cases, resulting in a direct increase in your quality of life. In addition, approximately 90% of patients have been able to make a complete return to playing sports, a rate unheard of for other spinal surgeries.
Through experience and advances in innovation in recent years, the procedure for artificial disc replacement surgery has improved markedly, making it the best option for those patients with cervical or lumbar degenerative disc disease.
The prostheses that are used today are highly resistant to wear and have a biomechanical behavior very similar to that of the natural spinal disc. This means safer surgeries with better clinical results. Find out more about the types of surgery and the surgical process below.
At New Delhi Spine we believe that the recommended surgery in cases of cervical and lumbar degenerative disc disease is the total (or almost total) replacement of the disc.
With total disc replacement (or almost total in some cases), we achieve the elimination of all the pain-causing agents: the degenerated nucleus, the degenerated and fissured ring, the synovertebral nerve endings and the degenerated endplate.
When this is done, the clinical result is usually very satisfactory, with good long term results in greater than 95% of cases. In addition, we are able to conserve the joint mobility.
Despite the fact that the medical advice of many surgeons continues to consider arthrodesis or spinal fusion as the surgery of choice, at New Delhi Spine we consider ADR to be the best option in cases of disc degeneration due to the advantages it presents and given the improvement in designs and materials that have taken place in recent years.
If you are considering artificial disc replacement surgery as one of the treatment options to solve the problem of spinal disc degeneration, you probably have many questions about the surgical procedure. So to answer your questions, in the following paragraphs we give you a detailed description of the steps involved in the operation.
At New Delhi Spine, in addition, we have the Dynamic Life Recovery System (DLRS) for Patient to guide them throughout the process, from getting prepared for the surgery and all the way through their
recovery periods.
Lumbar or cervical ADR surgery, like any surgical treatment, involves a detailed assessment of each case prior to the surgery. To have this done, patients should contact the New Delhi Spine to make an appointment at which they will be able to provide the specialist with all the necessary information.
In approximately one week after we have all your necessary information, you will receive the complete evaluation of your case from the specialist. In some cases, the doctor may tell you that some additional tests are needed before surgery. From this moment on, the preoperative preparation steps included in our DLRS program will be activated, which include specific protocols to reduce stress and make this stage of the process easier.
In the event that the patient has previously undergone any treatment (surgical or non-surgical) to treat the pain caused by the disc degeneration problem, it is important that you tell us so that the surgeon takes it into account before the intervention. Also, it is essential that you know your medical history and inform us of any medical conditions and any treatment that you are currently following.
When the scheduled date for the operation arrives, the protocols of our DLRS program for surgery are activated, which aim to facilitate this stage of the process.
The patient is admitted to the hospital on the day of the operation. They will need to abstain from eating or drinking anything for at least 6 hours prior to the scheduled surgery time. While waiting for the operation, the patient will be in a hospital room, where he or she can be accompanied by his family and friends.
After this, the patient will be taken to the surgical area where the anesthetist will ask them some questions and then the patient will be asked to sign an informed consent of the possible risks related to anesthesia.
Next, the operation, which usually lasts about an hour, will be performed by the spine surgeon at the lumbar or cervical level. Although it depends on each case, as a guideline, when the operation involves more than one level of spinal disc, each extra level takes about fifteen minutes more.
When the surgery is over, the patient is awakened in the operating room and transferred to a recovery area, where he is monitored for about two hours before being taken to their hospital room.
The discharge from the hospital will depend on each patient’s case. On the average, the patient stays for one day for cervical arthroplasty, and three days for lumbar arthroplasty.
It is totally normal for the patient to feel discomfort in the area of the surgical incision or in the cervical or lumbar area, but this will subside over the next few days.
Recovery from ADR surgery, whether cervical or lumbar, is a gradual process, and it is normal for the patient to notice some discomfort. During the first week after surgery, we recommend that the patient take short walks, and exert no effort that causes stress. A follow-up visit is scheduled for the patient between 7 and 10 days after surgery. At this appointment the surgical wound is inspected and the suture strips are removed, since no external stitches are applied in ADR surgery.
After that point, as a general recommendation, the patient should not exert any stressful effort or adopt bad postures during the first three months after surgery, and especially during the first month. They will be able to start swimming one month after surgery and run or ride a bicycle after the first 3 months.
After about 3 weeks, the patient can return to work if it does not require physical effort. For patients whose professional activity requires physical exertion, they can usually return to work about 6 weeks after the operation. In addition, we recommend that the patient have supervised rehabilitation sessions in a specialized physical therapy center.
Apart from the general recommendations, there are specific indications depending on whether the intervention was in the cervical or lumbar spine. At New Delhi Spine we do not recommend the use of lumbar belts on a routine basis. They are only indicated in some cases, for a short period of time, when the patient notices a certain abdominal distension.
On the other hand, we do recommend that patients who undergo cervical ADR wear a soft cervical collar - provided in the hospital, which can be removed for eating and sleeping - until the day of removal of the suture strips.
Of course, the recovery steps recommended will depend on each patient and will be made in a totally personalized way in each case. At New Delhi Spine we accompany the patient throughout the process. In addition, the staff continues to be available so that the patient can ask any questions about recovery through the usual channels such as telephone or email.
Postoperative discomfort or pain is normal, but at New Delhi Spine we do our best to ensure that this phase is as easy as possible for the patient.
During the hospital stay, the patient will receive painkillers intravenously to alleviate this post-operative discomfort.
Upon discharge, oral medication will be prescribed by the doctor according to each case. This will be gradually withdrawn on advice of the doctor at the following visits to New Delhi Spine.
The medication prescribed during and after hospital admission sufficiently covers the pain management needs of both cervical and lumbar ADR surgery.
After artificial disc replacement surgery, the patient will need to perform a series of prescribed postoperative recovery exercises:
The artificial discs we use are elastomeric ones, all of them third generation. This means that the core is made of an elastomeric material (specifically, polyurethane) that mimics the mechanics of the natural disc in the best possible way. We use Cervical Baguera disc or cervical ESP and Lumbar ESP devices.
ESP is a monobloc total disc prosthesis that restores natural disc functions The ESP disc prosthesis is made of two titanium alloy endplates and an elastomeric cushion. The spikes on the endplates outer surfaces improve primary fixation. The combination of a hydroxyapatite (HA) coating on top of a T40 rough surface are considered as one of the best existing coating. The titanium alloy used for the endplates allows clear medical imaging.
Between the two titanium endplates the elastomeric parts are injected for controled resistance to compression, flexion and rotation. These elastomeric parts are concentric and their fixation prohibits micromotion. The materials used for the implants have been tested for biocompatibility according to the ISO standard 10993.
Minimally invasive anterior approach which allows reduced hospital stay and improves rehabilitation.
Tested up to 40 million cycles.
ESP should give a significant reduction in pain severity, re-establish lumbar curvature and natural disc functions.
ESP allows quick return to normal daily activities.
In general, the vast majority of patients with disc degeneration problems are candidates for ADR surgery. Also in the case of athletes, it usually allows them to return to full activity and even competition within an estimated period of three months. In fact, at New Delhi Spine we are pleased to have seen how up to 70% of the patients operated on for lumbar ADR return to sports activity. Nonetheless, there are some exceptions in which a patient would not be a good candidate for this surgery:
When the state of their disc degeneration, ligaments and facets make this operation unadvisable.
It is rare to need this operation, because even when they suffer chronic back pain and degenerative disc disease, all efforts are made to try to manage it with conservative treatments.
We do not recommend this surgery for pregnant women because in the case of lumbar ADR, the surgery is performed with an anterior approach. For a pregnant woman suffering from low back pain, it is better to treat the problem with medication. The operation could be carried out about six months after she has given birth. It is important to note that it is safe for a patient who has had lumbar ADR surgery to get pregnant one year after the intervention. Regarding cervical ADR surgery, it would only be performed in cases of extreme need, that is, those in which there is compression on the cervical spine.
Are usually not good candidates for lumbar or cervical ADR surgery. The reason is that there is often an associated disc or ligament injury that results in segment instability.
ADR surgery has very few side-effects. Below are a few that we have seen over our 20 years of experience:
The spine specialist in our team who are trained in surgical technique from Australia performs the ADR and in the management of patients undergoing cervical and lumbar ADR
In our ADR FAQ section, we explain everything from the surgical procedure at New Delhi Spine (before, during and after the intervention) to which type of prosthesis we use.
Contact us so that we can give you a personalized assessment.
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