Multi-level disc replacement is an excellent option for people who have chronic neck and/or low back pain caused by two or more problematic discs. Multi-level disc replacement can relieve pain and improve function as well as multi-level spinal fusion, but preserves far more neck and/or low back spinal motion than multi-level fusion.
Multiple-level disc replacement, or multi-level disc replacement surgery, is a spine surgery procedure in which a spine surgeon replaces two or more natural spinal discs with artificial discs. Multiple-level disc replacement is performed on the cervical spine (neck) and in the lumbar spine (lower back). During the procedure, the damaged spinal discs are completely removed. Any areas that are pressing on spinal nerves or the spinal cord are widened and resolved. For each natural spinal disc that is removed, an artificial disc is put in its place. No instrumentation (rods, screws, plates) or bone grafts are needed.
Patients who have chronic neck and/or low back pain caused by disc disease at two or more levels may be a candidate for multi-level disc replacement. Disc disease may include spinal cord and/or spinal nerve impingement, herniated disc, spinal bone spurs, or a loss of disc height. The contraindications for multi-level disc replacement are the same as those for single- level disc replacement, namely, osteoporosis, cancer affecting the spine, and poor facet joints, i.e., facet joint degeneration.
If you have degenerative disc disease at two or more levels that has been causing neck or lower back pain for four weeks or more, talk to a spine surgeon who is an expert in multi-level disc replacement to find out if you are eligible for this type of surgery.
Cervical Multi-Level Disc
Replacements Cervical multi-level disc replacement surgery is a single spine surgery procedure in which two or more spinal discs in the neck are removed and replaced with artificial discs. Every disc in the cervical spine can be replaced; however, there is no spinal disc between C1 (atlas) and C2 (axis) cervical bones, which have unique shapes.
Lumbar Multi-Level Disc
Replacements Lumbar multi-level disc replacement surgery is a single spine surgery procedure in which two or more spinal discs in the lower back are removed and replaced with artificial discs. Every disc in the lumbar spine can be replaced, namely L1-L2, L2-L3, L3-L4, L4-L5, and L5-S1. Most patients have lumbar disc replacement surgery at L3-L4, L4-L5, and/or L5-S1 levels.
What is the benefit of multiple-level disc replacement surgery? Spinal mobility!
The reason that we can flex, bend, or turn our necks is because the bones in the cervical spine can tilt side -to -side, back-to-front, and can rotate. We can twist our upper body because each lumbar spinal bone allows it. When two spinal bones are fused together in spinal fusion surgery, the motion between them is lost forever. Now, if you have spinal fusion surgery at multiple levels, the loss of flexibility and mobility in the neck and/or low back is tremendous (and sad, frankly). However, if you have multiple-level disc replacement surgery instead of spinal fusion, the artificial discs mimic the natural discs and preserve motion between spinal bones.
Thus, the key benefit of multiple-level disc replacement surgery is that movement in the cervical (neck) and lumbar (low back) spine will be preserved. In addition, artificial disc replacement also puts less stress on the surrounding spinal bones than spinal fusion. This means that multiple-level disc replacement surgery is gentler to the surrounding spinal bones and joints than spinal fusion. Lastly, recovery after multiple-level disc replacement surgery is usually faster than with multiple-level spinal fusion surgery.
The risks of multiple-level disc replacement surgery are the same as single-level replacement. In general, the overall risk associated with multiple-level disc replacement surgery is low. The main complications of multiple-level cervical disc replacement surgery are pain, difficulty swallowing, difficulty speaking, infection at the disc, bleeding, recurrent laryngeal nerve injury, esophageal injury, tracheal injury, dural tear, hematoma, and spinal cord injury. The main complications of multiple-level lumbar disc replacement surgery are pain, infection at the disc, bleeding, dural tear, hematoma, and spinal cord injury. It is possible that a cervical or lumbar implant may fail or move to an undesirable location, but this is unlikely with newer artificial disc designs.
All patients who have issues with more than one of their spinal discs should consider multi-level disc replacement surgery. Indeed, if a doctor has suggested multi-level spinal fusion, it is important that you speak to a spine surgeon about multi-level disc replacement surgery before proceeding with fusion. Drs. Lanman and Cuéllar are pioneers in the field of multi-level disc replacement surgery. These spine surgery experts will evaluate your case, determine if spinal surgery is needed, and help you decide between multi-level disc replacement surgery and multi-level spinal fusion.
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