Criteria for a Good Candidate for Disc Replacement Surgery

Whether you’ve been told that you should have disc replacement surgery and are looking for a second opinion or you are researching different treatment options for the neck or back pain that you’re currently experiencing that don’t involve fusion, you might be wondering “Am I a good candidate for disc replacement surgery?” If so, this blog post is for you. In it, we will discuss what disc replacement of the cervical and lumbar spine are as well as what makes someone a good candidate for disc replacement.

What is Spinal Disc Replacement Surgery?

Disc replacement surgery is a surgical procedure that involves removing a damaged spinal disc and replacing it with an artificial disc. Also sometimes called artificial disc replacement or total disc replacement, this type of surgery can be performed in the cervical spine (neck) or lumbar spine (back).

When it’s performed in the neck, it’s referred to as cervical disc replacement surgery.

When it’s performed in the back, it’s referred to as lumbar disc replacement surgery, or sometimes just lumbar disc replacement.

While more invasive than minimally invasive spine surgery, disc replacement surgery is also less invasive than other types of open surgery like spinal fusion.

Who’s a Candidate for Spinal Disc Replacement Surgery?

The following factors make someone an ideal candidate for either disc replacement surgery of the neck or back:

• Age and Anatomy: There’s no fixed age requirement or even age limit for disc replacement surgery, but younger individuals with optimal spinal anatomy are typically ideal candidates.
• Healthy Weight: A healthy weight is essential, particularly for lumbar disc replacement, as the procedure often requires an abdominal incision.
• Disc Condition: The best candidates have “single-level isolated disc disease,” indicating that only one disc is significantly affected.
• Bone Quality: Robust, healthy bone density is crucial for successful implant positioning.
• Overall Health: Good general health enhances the likelihood of a smooth surgical process and recovery.

Contraindications for Disc Replacement (Who’s Not a Good Candidate?)

You might not be a suitable candidate if you:

• Have multi-level disc disease: Disc replacement surgery usually targets one problematic disc at a time. If multiple discs are in need of replacement, consulting a doctor for alternative treatment methods such as spinal fusion is recommended.
• Have arthritis: If you have arthritis, particularly in the facet joints, that might not be adequately addressed by disc replacement alone.
• Have spondylolisthesis (where one vertebra slips over another): This condition requires realignment and stabilization of the spine, meaning that disc replacement might not be an ideal treatment method.
• Have osteoporosis (reduced bone density) or poor bone quality: Disc replacement requires strong, healthy bones to support the artificial disc and ensure proper fusion.
• Have a vertebral fracture: A fracture in the vertebra can compromise the stability of the spine, making disc replacement unsafe.
• Have a spinal tumor or infection: These issues normally rule out disc replacement as a course of treatment.
• Are morbidly obese: Carrying a lot of extra weight can both increase risks of surgery and make performing it more technically challenging. For these reasons, most spine surgeons recommend that patients who are severely overweight lose weight first before qualifying for disc replacement.
• Have substantial damage to facet joints: When these joints are damaged or severely arthritic, disc replacement might not provide adequate relief.
• Have autoimmune conditions: Rheumatoid arthritis and other autoimmune conditions can disrupt the healing process after disc replacement.
• Have undergone specific prior back or abdominal surgeries: While previous back or neck surgery won’t automatically disqualify you from having disc replacement surgery, the extent of these prior surgeries and any scar tissue or anatomical changes they may have created could.  

What are the Alternatives to Disc Replacement Surgery?

Everyone’s neck and back pain stems from different causes. Depending on your unique situation and the condition(s) you experience, you may have other surgical or nonsurgical options at your disposal. We invite you to contact us here at Desert Spine and Scoliosis Center for a medical evaluation.