Top-trained spine surgeons advise on when to consider artificial disc replacement in 2021

Top-trained spine surgeons advise on when to consider artificial disc replacement in 2021

If you’ve been told you have a herniated disc, you probably have also been told you need a spinal fusion, which up to a year ago has been the traditional treatment for herniated discs. However, that advice for a spinal fusion — especially in the neck — no longer applies, according to Sanjay Jatana, MD, a fellowship-trained cervical spine specialist in Denver, who is featured in the educational website

“The most current spine research from the North American Spine Society has shown that artificial disc replacement can reduce the need for additional surgery at other levels in the neck,” explains Dr. Jatana.  “With spinal fusion, you are locking two vertebrae together. Fusion unfortunately puts extra stress on the discs above and below. The result can be an accelerated degeneration of the adjacent levels caused by spinal fusion. With an artificial disc, you are preserving motion which lessens the risk to other disc levels. This is especially important in the neck as you only have six disc levels to maintain needed motion.” The Centers for Artificial Disc was featured by 88 magazines, newspapers and TV stations across the United States in December 2020 with an article advising when back and neck pain patients should consider artificial disc replacement as an alternative to spinal fusion in either the neck or low back for treatment of herniated discs.

Artificial disc surgery — also referred to as motion preservation surgery — has rapidly evolved with new implants that replicate the rotation and shock absorption function of the healthy disc.  The FDA has approved several artificial discs for use at two levels in the neck, notes Dr. Craig Humphreys, a fellowship-trained spine surgeon located in Alaska.  Dr. Humphreys is one of few spine surgeons in Alaska proficient in artificial disc surgery in both the neck and low back, and is an inventor of the “Balanced Back” lumbar disc that can be implanted from the back of the spine rather than the front.  “These are exciting times for the field of spine, as each year there are new discs that not only preserve the natural rotation of the spine, but also provide some ability to compress up and down,” Dr. Humphreys notes.

While the benefit of disc replacement for many herniations in the neck has been proven, it’s important for the back pain sufferer to understand that with low back artificial disc surgery there are many considerations, and even proficient spine surgeons are cautious as to who qualifies.  “The fear of having a disc wear out requiring revision surgery requires a careful approach with lumbar disc replacement, explains Dr. Michael Rohan, Jr., a fellowship-trained spine surgeon at Northwest Florida Spine.  “While access to the front of the neck for artificial disc surgery is straightforward, that is not the case for the lumbar area. With traditional lumbar artificial discs, the surgeon must go through the abdomen and navigate around internal organs. If the disc wears out, that can require complex revision surgery. So most surgeons are cautious on which low back patients are appropriate for disc replacement.”

The burden is on the patient to become well informed about their treatment options, and to research a second opinion when they are told they need spine surgery, says Dr. Maahir Haque, a fellowship-trained spine surgeon at Spine Group Orlando in Florida. “It takes extensive training and experience to implant an artificial disc, and a relatively small percent of spine surgeons are really proficient in that. If you live outside a large metro area, you may have to travel for the most advanced spine care.”

Dr. Rohan, Jr. adds that there is a lot of confusing information pushed at the back or neck pain sufferer.  “Many surgeon websites are often biased about artificial disc, based on if they are proficient in the latest technology,”  Dr. Rohan notes. “The goal of is to provide an unbiased and prudent encyclopedia on the subject or artificial disc replacement and who qualifies.” 

The site provides an overview of the FDA-approved artificial discs for cervical and lumbar disc herniations, a free downloadable “Back in Motion Patient Guide,”  and articles authored by spine surgeons who specialize in disc replacement. All the physicians featured on are trained in artificial disc replacement surgery.

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