What is intervertebral disc prosthesis?

Medicine studies advance worldwide every day. The big achievements include implants, even hearts and lungs can be implanted to save people lives. One of these great advances is the implantation of intervertebral disc prosthesis, used to relieve pain and thus improve the quality of life. The artificial disc today has found a good place in the surgical treatment of disc damage and spinal disease.

The goal of implantation is to maintain the mobility and functionality of the spinal column by establishing a solid, bony connection with adjacent natural vertebrae after surgery. Disc replacement is available for use on the cervical and lumbar spine. The disc prosthesis consists of two metal plates (titanium or a cobalt-chromium-molybdenum mixture) and a core, usually made of polyethylene. They vary in size, shape, height and angle.

When is the implantation of intervertebral disc prosthesis an option?

When is the implantation of intervertebral disc replacement necessary? Basically after detailed discussion with our patients and after determining the cause of your complaints, we start with a targeted individual treatment. What is of course needed is your active participation, because even the best surgery cannot help if patients do not do anything for themselves. The implantation of intervertebral disc prosthesis is one of several treatment options we offer.

If conservative therapies (for example, physiotherapy and medication pain treatment) in cases with strong disc degeneration associated with herniated discs or protrusions do not work, we can replace the affected disc with disc prosthesis. There are also patients that suffer from disc damage at different levels of the spine. What gives advantage to the disc replacement therapy over a stiffening operation (spinal fusion) is that it maintains the mobility of the spine.

If you have osteoporosis, a tumor, a bacterial infection of the spine or advanced osteoarthritis of the small vertebral joints, a replacement of the intervertebral disc is not possible. In these cases, other alternatives would be considered.

Operation course - implantation of the disc-disc prosthesis on the lumbar spine

This surgery will be performed under general anesthesia, via skin incision of 6-centimeter-long on the lower abdominal area. The incision will be deepened to the muscle layers till the peritoneum (peritoneum). The peritoneum is then shifted to the side, in order to create, with special instruments a direct access to the front side of the lumbar spine (usually L5/S1). With the help of special surgical microscope and micro instruments we reach the affected intervertebral disc. The anterior longitudinal ligament (lat. ligamentum longitudinale anterius) is opened and here from the space between the vertebrae we remove the degenerated disc completely. If disc material (herniated disc) is present in the spinal canal, it will be also removed. Ossifications are also removed in order to give movement to the segment. Then we bring the vertebrae back to their original height and insert the prosthesis into the gap between them – which means we anchor them without cement, serving as a future placeholder and movement segment.

Through the rough surfaces of the metal plates, the prosthesis grows in the following weeks with the adjacent vertebral bodies, which means that the bone material grows in the coated base and covers the plates of the intervertebral disc prosthesis.

Right after surgery

The procedure takes place under general anesthesia and lasts approximately 60 minutes. After the procedure, our competent team will welcome you in your recovery where, as usual, your heart and lung functions are going to be monitored. Well-trained nurses won't leave you alone. The day of the operation we recommend you to rest well. Slight temporary swelling or muscle tension are treated.

The next days after the operation

The implantation of disc prosthesis requires the highly concentrated use of a first-class surgical team. Patients must follow doctor's instructions carefully in order to maintain the successful results of the treatment. Basically, your impatient stay will be of about 10 days but for a total recovery you will have to wait at least four weeks. Patients will also wear a lumbar bandage for 4-8 weeks. The frequency and direction of the lumbar spine movements must be determined by the doctor. Lifting and carrying heavy loads should be avoided. Before being discharged, your doctor will prescribe you an individual physiotherapeutic program for general relaxation of the muscles and later for their strengthening. The inability to work will be of about 8 weeks. Once you feel that the affected segments are “normal” again, you can start to move your spine. However: It is recommended not to drive for at least four weeks, as well as cycling. Golf and tennis are allowed, but after about ten weeks.

Advantages of an intervertebral disc prosthesis

Normally, with the implantation of intervertebral disc prosthesis you can expect to have a painless era in your life. Thanks to the modern disc prosthesis you get back a natural mobility of your cervical spine. You will especially appreciate that because the movement segment was significantly disturbed before the procedure. Another advantage is that by implanting one of these modern prostheses, the affection of the adjacent segments (the adjacent intervertebral discs) is significantly reduced.

The surgery allows a tissue-conserving approach (without damaging nerve roots), so you can recover quickly. Complications of this procedure such as bleeding or inflammation are rare. Even less frequently structures in this area can be injured. In about 15% of cases, the disc loses elasticity and stiffens.

Dr. med. Munther Sabarini

Author
Dr. med. Munther Sabarini
Specialist in Neurosurgery

Hans-Heinrich Reichelt

Co-author
Hans-Heinrich Reichelt
Chief Editor of Medizin für Menschen

The Avicenna Clinic in Berlin is always willing to help you

Since the year 2001, the Avicenna Clinic is based in Berlin. Our doctors have at least 25 years of international experience in their respective fields (neurosurgery, spinal surgery, anesthesia, and orthopedics).

If you have severe back pain, a herniated disc or a suspected herniation, please contact us using the following information:

Avicenna Clinic
Paulsborner Str. 2
10709 Berlin

Telephone: +49 30 236 08 30
Fax: +49 30 236 08 33 11
E-Mail: info@avicenna-klinik.de

You can call anytime, write an e-mail or fill out a callback form. Each patient then gets an appointment with a doctor of our clinic, who is a spine specialist (neurosurgeon). Based on MRI images (brought or made in our clinic) and on an in-depth examination, the doctor will discuss with you all the different therapy options or possibly surgery. You can also use our specialists only to obtain a (second) opinion.

If you decide to undertake your therapy and/or surgery in Berlin, we would want to make your stay as pleasant as possible. In our clinic, you are at the center of our attention! You can expect state-of-the-art equipment in all areas - from the operating room to the patient bedroom.

The latest, gentle, minimally invasive treatment procedures are the focus of our clinic. Together we try to find a suitable treatment for your complaints. The actual therapy takes place only after a detailed discussion with the patient, examinations and the diagnostics.

For us, as important as medical care, it is the commitment we take to guarantee our patients a high level of personal care that can, in turn, ensure them a comfortable stay.

During the period of inpatient stay our team of nurses will take care of you 24 hours a day. They also offer services in several foreign languages, including English, Russian, Polish, Turkish, Spanish, Italian, Arabic, Bulgarian and French. We care not only about your safety but also your needs, respecting traditions and religions.

Our team is made up of a group of highly qualified specialists who work together to guarantee you a quick recovery.