Making an Informed Choice: Lumbar Disc Replacement vs. Fusion

More than 16 million American adults live with chronic back pain. Researchers estimate that Americans lose 83 million workdays each year because of back pain and are significantly more likely to limit their social activities. It’s normal to occasionally wake up with a little pain if, for example, you slept in an awkward position, but if you regularly miss work and time with friends because of lower back pain, it’s time to seek help.

There are several potential sources of your lumbar (lower back) pain. These can be treated with both non-surgical and surgical options. If your doctor believes that you need an operation to address problems with your spinal discs, they might recommend lumbar disc replacement or spinal fusion. While fusion is a reliable surgical option, disc replacement is a modern and more effective alternative when it comes to maintaining your mobility. Learn more about the difference between these two operations so you can make an informed decision for your health.

What is the difference between a lumbar disc replacement vs. spinal fusion?

Before you can get into the differences between disc replacement and fusion, it helps to understand how your lumbar spine works. There are 24 vertebrae in the adult spine. These stack on top of each other and allow you to move and bend to navigate the world. To prevent the bones from knocking and rubbing together, there is a cushion in between each one – known as a spinal disc.

If you experience chronic lumbar pain, your doctor might check the health of your discs to see if one was pushed out of place (hitting the nerve canal) or is breaking down and no longer protecting your spine. If your spinal discs are worn out, they might recommend disc replacement or spinal fusion.

Lumbar disc replacement is the process of removing the damaged discs that are no longer protecting the vertebrae in your spine. After the surgeon removes the problem disc, they will replace it with an artificial model. These artificial discs are designed to last several decades and provide just as much cushioning as the natural discs in your body. As a result, your vertebrae are protected, your pain levels are lower, and you can work to regain your full range of motion.

Many doctors believe disc replacement is a better alternative to spinal fusion. In a fusion operation, the damaged disc is removed and then the doctor fuses the two (or more) vulnerable vertebrae together – usually using metal rods. This will prevent the vertebrae from rubbing together and causing you pain without the protective disc. Unfortunately, it also reduces your range of motion. You might find that you can’t bend or twist as much as you could before your spinal discomfort.

Lumbar disc replacement allows patients to return to their lives with less pain and greater mobility. This is why it is seen as more effective than fusion, which can limit patients’ mobility for the rest of their lives.

Benefits of Lumbar Disc Replacement vs. Fusion

There are several reasons to consider lumbar disc replacement over spinal fusion. The first is the increased mobility. The artificial discs are designed to simulate the ones your body naturally creates – the same discs that allow you to bend, twist, and generally move your body. Many patients who undergo lumbar disc replacement (and who follow their aftercare and rehabilitation instructions) can restore their mobility levels back to when they were pain-free.

Disc replacement is also seen as a better long-term solution for preserving the spine as a whole. People who undergo spinal fusion are at a higher risk of adjacent segment disease (ASD). While the spinal fusion restores stability to the two vertebrae affected by the disc removal, it can place other vertebrae in an unnatural position. This new – and often permanent – redistribution of pressure can wear out spinal discs and cause back pain to return. Essentially, ASD is a domino effect where the repair of one broken disc leads to the degeneration of another.

There is less of a risk of ASD with lumbar disc replacement because the artificial discs are designed to simulate the natural motions  in the body and your other vertebrae aren’t affected.

One final consideration with lumbar disc replacement vs. spinal fusion is the recovery time and invasiveness of the operation. Disc replacement is an outpatient procedure where most patients can return home within a few hours. The incision is only about an inch or two long, reducing your risk of infection. Spinal fusion is a more invasive procedure with a larger incision because the doctors need to install the rods and make sure the entire spine is stabilized before closing up the patient and letting them recover.

Should I have a lumbar disc replacement or fusion?

The decision to have lumbar disc replacement surgery is between you and your doctor. You need to decide whether this operation is a good fit for you while your doctor needs to confirm that you are a good candidate for surgery.

Your doctor might ask about your lifestyle to make sure you can fully recover from the operation. They need to know that you will have someone to care for you and that you can take time off from work and parenting to heal. Your doctor also wants to make sure that your habits (like smoking) and other medical conditions won’t interfere with the healing process.

Your doctor will also review the benefits of lumbar disc replacement over spinal fusion and cover which options they recommend. In some cases, fusion might actually be the better choice. Your doctor should explain why they are opting for certain treatment plans over others.

Every patient has unique needs when it comes to treating back pain. This is why personalized evaluations and consultations with spine specialists are so important. If you aren’t sure about moving forward with a treatment plan, get a second opinion. Another doctor might be able to provide more insight into your condition and help you make the best choice for your health.

Talk to Your Doctor About Lumbar Disc Replacement

You don’t have to live with chronic back pain. Talk to your doctor to see if the source of your pain is related to your spinal discs and, if so, whether lumbar disc replacement is right for you. A quality medical professional might recommend some non-surgical options first, but this is because they want to make sure less invasive options would be just as effective. Either way, your doctor will put you on a path to healing.

If you need a spine professional, work with the best. Contact leading spinal neurosurgeon Dr. Todd H. Lanman, founder of the Advanced Disc Replacement Spinal Restoration Center. Request a consultation today and commit to living without back pain.

Frequently Asked Questions (FAQs)

Are there any age limitations or specific conditions where lumbar disc replacement is considered more advantageous than fusion?

While there aren’t specific age limits for disc replacement surgery, your doctor wants to make sure you are a good candidate for this operation with a high chance of recovery. They will ask about other conditions and medications you have to make sure one won’t interfere with the other. Your doctor might also ask about your lifestyle (smoking, eating, drinking, and exercise habits) to better understand your life. If you are in good health, your doctor is more likely to approve you for lumbar disc replacement.

How does lumbar disc replacement preserve natural spinal motion compared to fusion?

Spinal fusion locks your vertebrae together and prevents them from moving – almost as if you glued two items together. Conversely, disc replacement removes the damaged material from your body and replaces it with a flexible recreation. Your spine is still able to move naturally because your vertebrae aren’t fused together. Many people report higher levels of mobility after they complete their lumbar disc replacement surgery.

What types of artificial discs are used in lumbar disc replacement?

Artificial discs are usually made of metal or a combination of metal and plastic. The metal used is either a medical-grade cobalt chromium or titanium alloy while the plastic is a medical-grade polyethylene. These materials are meant to be durable and long-lasting. Your doctor will ask about any allergies or reactions to certain materials when choosing the best option to ensure your body doesn’t try to reject the artificial disc.

What is the recovery process like after lumbar disc replacement?

The immediate recovery process from this operation will last between two to three weeks depending on the patient. It will then take about three months for you to completely recover and enjoy your full range of motion. You can ensure a safe and speedy recovery by following your doctor’s aftercare guidelines, attending physical therapy, and resting so your body can completely heal.

What can you not do after lumbar disc replacement?

Your doctor will review the activities you should avoid immediately after lumbar disc replacement. This includes avoiding showering for the first few days while the incision heals, heavy lifting, and standing for long periods of time. In the weeks following your operation, you will be approved to do more activities and return to work. After you fully recover from lumbar disc replacement, you should be able to work full-time and enjoy most of your favorite hobbies.