results vs risks

Results

Because total spinal disc replacement is relatively new, there hasn’t been much long-term follow-up to look at the success rates. In one study, patients who had spinal disc replacement had only slightly better outcomes compared to others who had intensive rehabilitation.

Unless your symptoms are severe, or you have pain, tingling or numbness in your arms and legs, your doctor may recommend you delay surgery until you’ve explored other treatment options.

Disc replacement may be an option for you if you’re in good health, you’re less than 60 years old, you have problems with only one disc, you have no spinal deformity or nerve problem.

Because this surgery replaces the disc (rather than fusing the spine, as with the alternative surgery, spinal fusion surgery), researchers believe that disc replacement may help maintain your spine’s natural mobility. This could be important if you’re still relatively young and/or active, because your spine would probably be more mobile. Theoretically, disc replacement may also prevent one of the negative outcomes of spinal fusion: degeneration of nearby parts of the spine. So far, however, it appears that both procedures are similar in this respect.

Risks

As with any medical procedure there are some potential risks. The chance of complications occurring depends on the exact type of procedure you’re having and other factors including your general health.

The main risks with disc replacement surgery are:

• tear of the dura (the protective sheath around the spinal nerves) which can cause a leak of spinal fluid (14%)
• infection (2–3%)
• post-operative bleeding
• nerve injury leading to weakness or numbness
• blood clots (deep vein thrombosis or pulmonary embolism)
• failure or displacement of the prosthesis.

Additional risks with cervical disc replacement are:

• temporary difficulty swallowing
• temporary loss of voice.

Additional risks with lumbar disc replacement are:

• injury to the small or large intestines
• injury to the ureters (tubes that bring urine from your kidneys to your bladder)
• temporary slowing of bowel movements
• retrograde ejaculation (5% of men). This is where a man’s semen goes into his bladder instead of out through his penis. It can cause infertility.

Long-term complications include:

• problems with the adjacent vertebrae
• wearing out of the prosthesis
• lack of pain relief (or worsening of symptoms)
• failure of the surgery, which may require further surgery or a different type of surgery such as (spinal fusion).

Ask your surgeon about the results and risks associated with your procedure. Also ask about their own rates of patient satisfaction and the rate of complications following the procedures they’ve performed.