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Lumbar Disc Replacement Surgery

In a Lumbar Disc Replacement surgery, the degenerated disc in the lower part of the spine is replaced with an artificial disc made of metal or a mixture of metal and plastic. The procedure aims to alleviate back pain while maintaining posture and motion.

Indications for the surgery:

Bones degenerate due to aging, obesity, overuse due to high impact sports or strenuous activities, degenerative disc diseases, spinal stenosis, and disc-related back pain. 

Not everyone with lower back pain is eligible for lumbar disc replacement. They have to meet specific criteria like:

  1. The majority of back pain must be attributed to 1-2 discs in the lower spine and verified through necessary tests.
  2. Should not be overweight.
  3. There must not be any severe disorders of facet joints or compression of the spinal nerves.
  4. The patient must not have a history of prior spinal surgery.
  5. There must be no deformity in the spine.

Diagnosis & Tests:

To meet these criteria patients have to undergo certain tests like a physical examination of the spine, MRI, CT Scan, X-ray, Discography, and blood tests.

The pre-surgery procedure:

  • The orthopedic surgeon will conduct a physical exam of the spine to evaluate the condition. It is followed by the necessary diagnostic tests mentioned above.
  • The doctor must be informed about the medical history, medications, and allergies of the patient.
  • A candidate who meets the requisite criteria is advised to stop certain medications, reduce weight, ensure a healthy diet, and stop smoking before the surgery.  

The surgery:

  • The patient is given general anesthesia before the procedure. The surgery lasts for 2-3 hours.
  • A catheter is placed to facilitate urination.
  • The orthopedic surgeon and vascular surgeon collaborate in the surgery. An incision is made in the abdomen. Organs and blood vessels are relocated to the side so that the spine can be accessed without affecting the nerves.
  • The surgeon replaces the affected disc with a prosthesis.
  • The organs are placed in their original position, and the incision is closed

The post-surgery procedure:

  • The hospital stay after the surgery varies, depending on the extent of the surgery and the speed of recovery. 
  • If required, pain meds are administered. Patients are encouraged to walk a day after surgery. 
  • The recovery rate is faster in this surgery as bone healing is not required.
  • Physical therapy is required for faster rehabilitation and recovery.
  • Patients need to be careful not to aggravate the back. 
  • Regular follow-ups with the surgeon are a must. 
  • As the healing process progresses, the patient is encouraged to start light exercises to aid the recovery process. 

Risks and Complications:

Like any surgery, lumbar disc replacement surgery has its risks and complications. Some common complications after the surgery are

  1. Infection of the area: It is rare. In case it happens, the patient is given antibiotics. In cases of severe infection, removal of the implant might be needed.
  2. Migration of the endplates: It usually occurs due to a discrepancy in the initial positioning of the implant. In this case, an immediate replacement of the components is done.
  3. Disc dislocation.
  4. Loosening or wearing out of the implant: Long-term studies suggest that wearing out of the implant is uncommon.
  5. Implant failure or fracture: Brace immobilization is the treatment of choice in such cases. 
  6. Stiff or rigid spine.
  7. Badly positioned implant.
  8. Narrowing of the spine.
  9. Blood clots.
  10. One of the most significant risks of this surgery is the possibility of paralysis due to the severing of the nerves. 

Lumbar Disc Replacement Surgery Cost:

The lumbar disc replacement surgery costs in India range from Rs. 1,89,000 to 8,50,000. However, it varies depending on the hospital and various other factors involved like:

  • Location of the hospital: The hospital in a metropolitan city will charge more than a hospital in smaller towns. Choice of the hospital: The more the amenities provided by the hospital, the more will be the charge.
  • Diagnostic tests: The tests are crucial; however, the charge varies depending upon where they are performed.
  • Medical treatment: The quality, and therefore the cost of the treatment varies from one facility to another. 
  • Surgeon’s fees: The more experienced surgeons demand higher fees.
  • Duration: The duration of the stay at the hospital and the associated medical care add to the cost. 

Conclusion:

  • The surgery is available in India at much lower rates compared to Western countries. The overall cost is significantly less compared to the developed countries, though the quality of treatment is at par with the best in the world. 
  • The ideal recovery period is considered a few weeks to a few months. The surgery does not eliminate the pain; however, it lessens it considerably. It is advisable to have a realistic conversation with the doctor regarding the prognosis, risks, and complications associated with the surgery, along with the do’s and don’ts, and the post-surgery follow-up schedule.  
  • A drawback of the surgery is that it is not covered by several medical insurance organizations. It is thus advisable to consider this aspect before opting for the surgery.

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