Motion Preservation Spine Surgery

• What it is: Artificial disc replacement is a surgical technique in which a degenerated or damaged spinal disc is removed. An artificial disc made from metal or plastic is then used to replace the compromised spinal disc. Unlike fusion procedures, ADR maintains natural spinal motion, allowing for continued flexibility and function. Patients undergoing ADR often experience reduced pain, improved mobility, and a quicker return to daily activities. Artificial disc replacement can be performed in the neck or lower back.
• How it works: The goal of ADR is to preserve the natural motion of the spine. Unlike spinal fusion, which fuses vertebrae together, ADR allows the spine to continue moving in the same way it did before the injury or degeneration, helping to maintain flexibility and reduce pain.
• When it’s used: ADR is typically used when patients have DDD or herniated discs, particularly in the lumbar (lower back) or cervical (neck) spine regions. 

Common Questions

Explore some of the common questions around ADR procedures:

What Is the Cost of Lumbar/Cervical ADR, and Is It Worth It? 

The cost of a lumbar or cervical ADR depends on: 

• The type of disc used.
• The surgeon’s fees.
• Hospital or surgical center charges.
• Whether it’s a cervical or lumber ADR.

Consider the following to determine if ADR is worth it for you:

• Degree of pain
• The pain’s impact on quality of life
• Your individual goals and expectations
• If conservative treatments have failed

What Are the Pros and Cons of ADR?

Some pros include:

• Pain relief.
• Improved function.
• Potential lowered risk of Adjacent Segment Disease (ASD).

Cons to keep in mind:

• Surgical risks, like anesthesia complications and infection.
• Potential disc dislocation.
• Not all patients are candidates.

Who Is a Candidate?

Any adult who has been experiencing significant lower back pain for a minimum of six months and where conservative treatments don’t bring full relief is a candidate.

What Is the Success Rate? 

When patients are appropriately selected and pass candidacy, ADR has a relatively good success rate, averaging over 85%. 

How Long Does an ADR Last?

ADR devices should last a few years, according to most manufacturers. ADR procedures that have been done five to 10 years ago still show promising results.

Does Insurance Cover ADR?

Yes, most major insurance providers cover ADR, but the coverage is based on the cost of the procedure, risks, and outcome benefits.

How Long Does It Take to Recover From ADR? 

Different recovery times apply to lumbar and cervical ADR:

• Cervical ADR: Recovery time is usually short, and you can engage in light exercise within a week after the procedure.
• Lumbar ADR: With lumbar ADR, the abdomen has to heal, and you can start with low-impact exercises by the second month after having the surgery.

• What it is: Dynamic stabilization involves the implantation of devices designed to stabilize the spine without completely restricting its movement. These devices may include flexible rods, plates, or screws that allow controlled motion while supporting the vertebrae.
• How it works: The goal of dynamic stabilization is to provide stability to the spine while preserving its natural motion. This technique is often used in cases where there is spinal instability, but fusion is not required.
• When it’s used: It is often used in patients with conditions like spondylolisthesis, mild to moderate DDD, or facet joint arthritis, where some stability is needed but full fusion is not necessary.

What Devices Are Available?

There are various devices that fall into certain categories. The device used depends on the patient’s condition, the surgeon’s preference, and whether the surgeon is operating on the cervical or lumbar area of the spine. For example, interlaminar devices provide support at the back of the spine, while total facet replacements replace the entire facet joint.

• What it is: Spinal decompression surgery is a procedure in which a surgeon removes tissue, bone spurs, or herniated disc material that is compressing nerves in the spinal cord or nerve roots.
• How it works: The surgery aims to alleviate nerve compression, which can lead to pain, numbness, or weakness. Techniques used in spinal decompression include laminectomy (removal of part of the vertebra), microdiscectomy (removal of disc material pressing on the nerve), or foraminotomy (removing a part of the facet that causes foraminal stenosis).
• When it’s used: It is commonly used to treat conditions like spinal stenosis, herniated discs, bone spurs, or other forms of nerve compression.

• What it is: Endoscopic spine surgery is an ultra-minimally invasive procedure in which the surgeon uses a small camera (endoscope) and specialized instruments to perform the surgery through tiny incisions (1/4 incision).
• How it works: The endoscope allows the surgeon to view the inside of the spine and operate with great precision, minimizing damage to surrounding tissues. This is typically done for decompression or disc removal procedures.
• When it’s used: It’s often used for herniated discs, spinal stenosis, and DDD, providing faster recovery and less postoperative pain compared to traditional open surgery.

• What it is: These procedures are designed to treat vertebral compression fractures caused by conditions such as osteoporosis or spinal tumors. Both procedures involve the injection of bone cement into the fractured vertebra to stabilize it and restore its height.
• How it works: In kyphoplasty, a balloon is first inserted to create space within the vertebra, and then the cement is injected. With vertebroplasty, the cement is directly injected without the balloon procedure.
• When it’s used: Kyphoplasty and vertebroplasty are effective for treating pain and restoring function in patients with compression fractures.

• What it is: Cervical disc arthroplasty is a specific type of artificial disc replacement for the cervical (neck) spine. During this procedure, a licensed surgeon removes a damaged cervical disc and replaces it with an artificial disc to preserve motion in the neck.
• How it works: The artificial disc emulates the natural disc’s function, allowing the cervical spine to move naturally while alleviating pain.
• When it’s used: It is used for individuals with neck pain caused by conditions like cervical disc degeneration, herniated discs, or DDD.

• What it is: This procedure is similar to dynamic stabilization, but the devices used are placed through the back (posterior) approach. An example of a device is the Coflex® Interlaminar Stabilization® device.
• How it works: The surgeon implants dynamic stabilization devices in the back of the spine to stabilize the vertebrae while maintaining the spine’s natural motion. This type of surgery often avoids the need for fusion in cases of instability.
• When it’s used: It’s often used for conditions like spinal instability or DDD, providing support while preserving motion.

• What it is: The TOPS™ Lumbar Motion Device is an alternative to traditional spinal fusion surgery, preserving the spine’s natural range of motion.
• How it works: It’s typically implanted through a posterior approach, allowing patients to maintain functional movement while addressing underlying spinal issues. The device provides stability, relieves pain,  and helps prevent further degeneration of the spine.
• When it’s used: It is used to treat severe DDD and other lower back conditions.

• What it is: Facet joints play a crucial role in supporting and stabilizing the spine. By restoring stability without sacrificing mobility, patients can find relief from facet joint pain and regain their quality of life.
• How it works: Facet joint replacement involves replacing damaged joints with artificial implants designed to preserve motion and function. 
• When it’s used: It’s used when the spine becomes damaged or degenerated due to conditions such as arthritis or injury.

• What it is: Interlaminar devices, also known as interspinous process devices, are implants placed between the spinous processes of adjacent vertebrae to help maintain spacing and stability in the spine.
• How it works: The devices provide support while preserving mobility. Interlaminar devices offer a minimally invasive alternative to traditional spinal fusion procedures. 
• When it’s used: These devices are often used to treat conditions such as spinal stenosis or DDD, where maintaining spinal motion is essential for symptom relief. 

• What it is: This minimally invasive procedure, which can be performed endoscopically, targets nerve compression in the cervical spine by removing a portion of the lamina and foramen, relieving strain on the spinal nerves.
• How it works: By precisely targeting the affected area, patients can experience pain alleviation and improved mobility with minimal disruption to surrounding tissues. 
• When it’s used: It’s typically used to treat bone spurs, DDD, and herniated discs.

• What it is: This procedure helps alleviate stress on the spinal cord, restoring mobility and function.
• How it works: It creates more space within the spinal canal while preserving the posterior elements of the vertebrae.
• When it’s used: It’s used in cases of cervical spinal stenosis, where there is a narrowing of the spinal canal. Cervical laminoplasty offers a less invasive alternative to traditional laminectomy. 

• What it is: Similar to its cervical counterpart, lumbar laminoplasty aims to address spinal stenosis in the lumbar region while preserving spinal motion.
• How it works: This procedure expands the space within the spinal canal without sacrificing stability.
• When it’s used: Lumbar laminoplasty assists in relieving symptoms such as leg pain and numbness while maintaining mobility.

• What it is: This innovative procedure targets the basivertebral nerve, which is implicated in the generation of chronic lower back pain.
• How it works: By using minimally invasive techniques, such as the Relievant Intracept™ Procedure, to selectively denervate the affected area, patients can experience significant pain relief and improved function without the need for fusion or extensive surgery. 
• When it’s used: This procedure is commonly used to treat chronic lower back pain and single-level pain sources and, in some cases, where conservative treatments have failed.