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Lumbar Disc Replacement Surgery

What is Lumbar Disc Replacement?

Lumbar disc replacement surgery is a type of surgery that involves replacing a damaged or diseased disc in the lower back (lumbar region) with an artificial disc. The goal of this procedure is to relieve back pain while maintaining more normal motion than traditional spinal fusion surgery, which joins two vertebrae together and can limit movement.

Lumbar Disk Replacement and Low Back Pain

Low back pain is a significant cause of disability in the U.S. and worldwide. It is estimated that 70% to 80% of people will experience low back pain at some point in their lives.

Artificial lumbar disc replacement is a newer surgical procedure for relieving low back pain. Similar to hip or knee joint replacements, a disc replacement substitutes a mechanical device for an intervertebral disc in the spine. The device is meant to restore motion to the spine by replacing the worn, degenerated disc. 

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It is typically seen in the lower back and is usually accompanied by straightening of the spine from the side. Pain, stiffness, numbness and shooting pain down the legs are seen in symptomatic patients (SRS, 2015).

LUMBAR DISC REPLACEMENT CONSULT

To determine who is a good candidate for lumbar disc replacement, the surgeon may require a few tests. These may include magnetic resonance imaging (MRI), discography, computed tomography (CT or CAT scan), and x-rays. These tests will also help the surgeon determine the source of the pain.

Good candidates for disc replacement have the following:

  • Back pain thought to be caused mostly from one or two intervertebral discs in the lumbar spine
  • No significant facet joint disease or bony compression on nerves
  • Not excessively overweight
  • No prior major surgery in the lumbar spine
  • No deformity (scoliosis)

TREATMENT

Artificial disc replacement in the lumbar spine has emerged as an alternative treatment option to lumbar fusion surgery for low back pain.

Lumbar fusion surgery remains the “gold standard” for treating low back pain patients who are not helped by nonsurgical methods and many people find relief with lumbar fusion, however the results of fusion surgery vary. For example, a patient with spinal stenosis who has a fusion procedure may have a very different outcome from a patient who has a fusion to help back pain that is caused by disc degeneration. In addition, some patients whose fusion surgeries heal perfectly still end up with no improvement of their back pain.

Herniated Disc in Spine

The artificial disc offers several theoretical benefits over the spinal fusion for chronic back pain, including:

  • Potentially enhanced clinical success rates (pain reduction)
  • Potential to avoid premature degeneration at adjacent levels of the spine by maintaining normal spinal motion

LUMBAR DISC REPLACEMENT PROCEDURE/TECHNIQUE

The surgical implantation procedure is performed through an incision in the abdomen (similar to an anterior lumbar interbody fusion).

With this approach, the organs and blood vessels must be moved to the side. This allows your surgeon to access the spine without moving the nerves.

Usually, a vascular surgeon assists the orthopaedic surgeon with opening and exposing the disc space. Most surgeries take about 2 to 3 hours.

Disc Design
The disc replacement device may comprise the nucleus (center) of the disc while leaving the annulus (outer ring) in place, although this technology is still in an investigative stage.

In most cases, total artificial disc replacements substitute the annulus and nucleus with a mechanical device that will simulate spinal function.

There are a number of different disc designs. Each is unique in its own way, but all maintain a similar goal: to reproduce the size and function of a normal intervertebral disc.

Some of the discs are made of metal, while others are a combination metal and plastic, similar to joint replacements in the knee and hip. Materials used include medical grade plastic (polyethylene) and medical grade cobalt chromium or titanium alloy.

Meet

Dr. Hamid R. Mir M.D.

Orthopedic Spine Surgeon & Back, Spine, & Neck Specialist

Dr Hamid Mir is a board certified orthopedic spine surgeon & back, spine, & neck specialist with fellowship training in combined neurosurgery and orthopedic spine surgery. He has offices in Orange County, Los Angeles & Riverside. Dr Mir specializes in spinal fusion, lumbar surgery and treating trauma as well as other conditions affecting the lumbar, thoracic, and cervical spine including degenerative diseases, stenosis, fracture, infection, adult scoliosis, revision, and complex reconstructions.

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Testimonials

You are more than just a patient.

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I was in a very bad situation with a herniated disc in my lower back so I made an appointment with DISC spine center and Dr. Hamid. He was very professional and made me comfortable that he understood exactly what I was going through and was able to communicate effectively exactly what it will take to get me on the road to recovery after spine surgery. It took several months as my injury was severe however I always felt I was in good hands under Dr. Hamid’s supervision…If you ever have the misfortune of injuring your circuit board of your body (spine) you need a pro, do not take advice from anyone who’s not specifically licensed to help, Dr Hamid is who I chose and I’m very thankful.

- Matteo B

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Dr. Mir saw me about 2 months before the spine procedure and indicated that I had severe stenosis or narrowing of the openings where the nerve roots exit at the L4, L5 and S1 level. He reviewed my MRI and without wasting any time, asked if I wanted or was considering spinal surgery. He was extremely clear and answered all my questions. I had the procedure done at the Disc Newport OP surgery spine center and was cared for by an incredibly competent, caring staff. I was discharged same day and my post op recovery was 2 weeks, and returned to daily activities and work July 15th. The procedure was very successful as my back pain is basically gone. Amazing relief from a procedure done by a great surgeon with a great team!

- Stan W.

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Dr Mir is an excellent spine surgeon. I had a surgery on my neck by another surgeon but I was still in pain. A friend who had prior spine surgery with Dr. Mir recommended him to me. As the treating surgeon he was very detail oriented, confident, and knowledgeable. His team is very friendly and helpful. I decided to have a second cervical spine operation on my neck. Soooo thankful I have no pain and for physical medicine doctors like him.

- Hillary C.

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Dr. Mir and his entire team of specialists take the extra time and consideration to shape alternatives to meet the needs (holistically) of the patient. Everything about the experience of my surgery was positive. Dr. Mir is a patient and compassionate surgeon. His communication skills are remarkably attentive. We are six months out of the starting gate from surgical treatment, and with PT and core strengthening exercises, this 65 yr. old is back to regular training for next year’s marathon. Thank you kindly El Doc-tor….you are amazing! See you soon.

- Lorena B.

Dr. Hamid Mir is a member of American Board of Orthopedic Surgery with fellowship training in combined neurosurgical and orthopedic spine surgery at Cedars Sinai Medical Center in 2004. As a top rated spine surgeon, he specializes in cervical, thoracic, and lumbar spine diseases including degenerative, stenosis, fracture, infection, scoliosis, revision, and complex reconstructions.

Dr. Mir focused his practice on minimally invasive techniques. As Medical Director of DISC Sports & Spine Center, Dr. Mir is at the forefront of the field of minimally invasive spine surgery. The benefits of these techniques include less post-operative pain, quicker recovery reduced blood loss, less soft tissue damage, smaller surgical incisions, less scarring and improved function.

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