Intervertebral disc replacement is a microsurgical technique for implanting a disc implant after total disc removal. Such a replacement operation allows you to reliably stabilize the affected segment and restore its lost weight-bearing functions. Prosthetics restore mobility and shock absorption at the discectomized level, close to normal values. Thanks to the introduction of a special replacement device between the two vertebral bodies, the patient is relieved of compression of the nerve roots, pain and neurological disorders recede, and the performance of the problematic part of the ridge is significantly improved. Complications occur in isolated cases, the risks of an unfavorable outcome are 1%-2%.
Installation visualization.
Artificial discs that allow vertebral movement and shock absorption began to be used relatively recently, but have already gained high popularity. Their installation has become possible since 2004 after the approval of the methodological approach by the relevant medical authorities. During the use of functional interbody prostheses in spinal neurosurgery, expert reviews boil down to the fact that this is the best alternative to traditional spinal fusion. Let's explain why.
Spinal fusion.
Bone fusion with rigid stabilization has too high prerequisites for the occurrence of degenerative diseases of the adjacent level. After making such serious changes to the spinal system, a restructuring of biomechanics inevitably occurs. The adjacent lower or overlying segments are more often affected. Since the area blocked by the bone block is motionless, a compensatory reaction occurs: the load on the adjacent vertebrae and joints increases, their mobility increases, and the pressure in the adjacent intervertebral discs increases. This provokes destructive processes in nearby osteochondral structures.
If the biological disk is not viable, its complete replacement with an elastic or elastic type device is justified from a physiological point of view. The prosthetic system will take over the motor-supporting and shock-absorbing functions of the missing cartilaginous plastic, and will not completely deprive a separate part of the spine of its motor potential, as is the case with spinal fusion. But most importantly, implantation of a “working” organ made of artificial materials will avoid overloading the adjacent level and minimize the likelihood of rapid development of degenerative-dystrophic changes in it.
Not many clinics in Russia perform disc replacement with an intervertebral endoprosthesis; the price of an operation of the 1st category of complexity here is approximately 300 thousand rubles. An implantable device costs about 200 thousand rubles, and 100 thousand rubles. include surgeon's services, anesthesia, and medications after surgery. The operation can be performed on the lumbar and cervical regions. Instead of the “native” damaged intervertebral disc, the following models are often implanted:
- DCI;
dci - Bryan;
bryan disc - M6;
M6 spine implants - SBCharite;
SBCharite - DePuy;
DePuy - AcroMed.
The mechanics and spring functions are most fully restored by products in the design of which, between the metal end plates, there are simulators of the nucleus pulposus and annulus fibrosus, made of an elastic polymer material. These are Bryan, M6. They provide controlled amplitude and softening of axial load in all 6 planes of motion, including compression and extension, just like a natural disc.
Models that assume permissible rotation of the vertebral bodies around one axis and shock-absorbing properties have somewhat less capabilities. They usually consist of two plates, between which an elastic spring is firmly fixed. All parts of the devices are made of metal.
Artificial intervertebral discs are developed taking into account the physiological characteristics and biomechanics of spinal motion elements. Therefore, they take root well, very rarely cause negative reactions, are not felt in the spine, and function correctly and gently. They are made of high-tech materials with the highest degree of biocompatibility and wear resistance - titanium or titanium alloy, high-density polyurethane, ultra-high molar mass polyethylene.
Information: Intervertebral disc replacement
- Duration of stay in the clinic:
2 days after prosthetic disc replacement in the cervical spine and 10 days in the lumbar spine - Inpatient rehabilitation:
14 days after cervical disc replacement and 21 days for lumbar disc replacement - Earliest time to fly home:
7 days after cervical disc replacement and 21 days for lumbar disc replacement - Recommended time to fly home:
14 days after cervical disc replacement and 21 days for lumbar disc replacement - Showering is possible:
7 days after prosthetic disc replacement in the cervical spine and 10 days in the lumbar spine - Duration of disability:
4 weeks after both surgeries - Removal of sutures:
after cervical disc replacement there are no stitches, 14 days after lumbar disc replacement - Driving a car is possible:
7 days after prosthetic disc replacement in the cervical spine and 28 days in the lumbar spine - Cost of the operation:
12,000 EUR regardless of department
medical request
When is intervertebral disc replacement necessary? © Spinal Kinetics
How much does a bone transplant surgery cost?
The cost of spine surgery has many details, including:
- Cost of medical examination
- Cost of diagnostics and tests
- Hospital expenses
- duration of stay
- Laboratory expenses
- Cost of medicines
- Cost of treatment regimen after surgery
- Cost of subsequent sessions
- In general, the cost of a spine transplant and fusion varies greatly depending on your insurance, where you live, and the hospital or doctor you choose. If you have health insurance, the average cost of a spinal fusion is $53,577, and if you don't have insurance, it increases to $157,026.
When is a complete spinal disc replacement necessary?
Total disc replacement is necessary for patients suffering from a pinched nerve in the lumbar spine due to degenerative disc disease.
For more than ten years, intervertebral disc prostheses have been in a constant state of development. After numerous modernization processes, artificial discs have become a significant and reliable alternative for the treatment of degenerative changes in the intervertebral discs.
Modern M6 intervertebral disc prostheses
are an excellent alternative to the previously known and successful operation for vertebral fusion.
Advantages of intervertebral disc replacement compared to spinal fusion:
- Maintaining spinal mobility
- Fast recovery and recovery after surgery
- Long-term improvement in body biomechanics (flexibility and mobility)
- Opportunity to return to professional activities and sports in a short time
- No wear to adjacent spinal segments
- Implantation of an M6 disc prosthesis restores the natural mobility of the human spine
For several years, spinal fusion was the only treatment for pain in the lumbar spine.
This method was also used for fixation in various deformities. With each decade, the methods of achieving a bone block through spinal fusion have improved. Despite this, with spinal fusion there is a risk of degenerative changes in the vertebrae, as well as wear of the intervertebral discs (discopathy) in adjacent segments of the spine.
Spinal fusion is a safe and effective method, but has a negative impact on the dynamics and biomechanics of the human spine, which can limit the patient’s mobility.
Over the years, intervertebral disc replacements have been improved to the point that they are now a successful and reliable alternative for the treatment of intervertebral disc degeneration.
Modern M6 intervertebral disc prostheses are an excellent alternative to the already proven above-mentioned method of spinal fusion.
The essence of the procedure
General anesthesia is used for the operation.
The spinal surgeon makes a minimal incision (3-5 cm), spreading the muscles and tissues apart. The incision is used to remove the damaged disc. Using a microscope, the surgeon frees the pinched nerve and begins implanting the prosthesis. At the Top Ichilov clinic, a unique M6-L implant is used for vertebral prosthetics. The prosthesis is a structure of a movable rod, which is made of medical plastic, and two plates on its two sides, which are made of a special cobalt alloy. Due to the use of plastic, the structure is quite elastic and movable, metal parts ensure its durability.
This implant is installed in the disc space, in place of the removed disc. After a certain time after surgery, bone tissue grows on the prosthesis, thereby strengthening it and ensuring its stability.
The operation is performed under the control of neuronavigation equipment, in particular, the O-ARM system, which records every moment of the operation from different angles. The surgeon can set the parameters of X-ray images that will help him track every stage of the operation and avoid even the slightest inaccuracy. After the implant is installed, the tissues are sutured, the patient is moved to the ward under the supervision of doctors. The operation lasts about two hours. On the second or third day the patient can already get up. The length of stay in the hospital is about three to four days. The period of complete restoration of spinal mobility is about six months. Before discharge, the doctor gives detailed recommendations that will make rehabilitation more successful.
Implantation of a prosthetic intervertebral disc does not have a negative impact on your mobility
Rice.
3: The artificial intervertebral disc can move in six dimensions of the natural mobility of the spine © Spinal Kinetics The natural intervertebral disc maintains the mobility of the spine in any angle and acts as a shock absorber. To avoid loss of natural mobility of the spine, the prosthesis must have the same property.
It is worth noting that only with the help of modern technologies for intervertebral disc replacement (M6 intervertebral disc prosthesis) has it become possible to preserve the natural dynamics of the human spine.
Lumbar disc prosthesis M6-L
designed to restore the anatomy and physiology of the intervertebral disc. In addition, it supports the natural biomechanics of the spine, providing a reliable and long-term solution to the problem.
Artificial intervertebral disc?
Rice.
4 The prosthesis consists of two hinges, each of which consists of a plate with a friction unit insert. The surface of the plates follows the anatomical shape of the vertebral bodies, which reduces damage at the time of implantation and reliably stabilizes the endoprosthesis. © Spinal Kinetics Modern intervertebral disc implants contain a moving core that provides movement in all directions, similar to a natural biological disc.
This invention provides stable and reliable fixation of the vertebrae, which, in turn, prevents displacement in any direction. In addition, a more complete restoration of the anatomical structure of the spine and its functionality is achieved.
Types of Bone Grafts
Bone grafting has two main types, including natural grafts and artificial grafts. The natural graft itself is divided into three subcategories.
Natural graft
Autograph
A graft that is taken from the patient's own bone. This transplant is best because it meets gold standards, including bone cells, proteins and bone matrix, all of which help stimulate fusion. In addition, the chances of success are even higher.
Allograft
An allograft is a bone graft from a donor who usually dies and whose organs were donated for medical purposes. Allograft bone does not contain living bone cells and is therefore weaker than autograft, which promotes fusion.
Xenografts
This is a type of bone graft obtained from cow bone.
Bone graft replacement (artificial bone)
Manufactured artificial bone, or a manipulated version, is a natural product that is used as an alternative to grafting and allograft. These synthetic materials have properties similar to those of human bone, including a porous structure and fusion-promoting proteins. These grafts include DBM, hydroxyapatite, calcium sulfate, tricalcium ceramic phosphate (TCP), bone morphogenetic protein (BMP), and bioactive glasses.
Advantages of an artificial intervertebral disc
The M6-L lumbar disc prosthesis fully matches the structure of the intervertebral disc. A similar result could be achieved with the help of an ultra-modern design that performs the functions of the fibrous ring, as well as the nucleus pulposus. Experience with endoprostheses of this type shows only positive results.
Many patients have already been able to verify the quality of this method, offered in famous clinics in Germany: it is a reliable and safe intervention that relieves patients with lumbar disc degeneration from pain and gives longer-term results than the established method of spinal fusion.
You can find out if this method can help you or a family member by clicking on the link below.
medical request
Risks of decompression surgery with a posterior approach
- Damage to the nerve root and spinal cord
- Recurrence of disc herniation
- Dural leak (a condition in which the thin covering of the spinal cord, called the dura mater, is damaged by the surgeon's instrument)
- Infection may occur during surgery as the deep internal parts of the body are exposed to air for a long time
- Some blood loss is inevitable as this is a complex surgical procedure and the surgeon must cut through various tissues
- Continued pain in the neck or surgical site
Surgery on the cervical spine is recommended by a doctor only if medications and other non-surgical procedures, such as physical therapy, exercise therapy, etc., do not relieve symptoms or restore stability of the motion segments.
As a rule, modern surgical techniques allow the patient to recover within several months. However, one must understand that any surgical intervention, especially in the cervical spine, is very stressful and does not bring the state of health to the point where surgery can no longer be avoided.