Lumbar Arthroplasty Surgery: Details You Need to Learn Before The Procedure

A range of spinal conditions can lead to chronic lower back pain. When this pain doesn’t respond to non-surgical treatment options, your doctor may recommend lumbar arthroplasty.

Lumbar arthroplasty is a surgical procedure that can resolve symptoms of spinal conditions including spinal stenosis, spondylolisthesis, and facet joint arthrosis.

Below, you’ll find a detailed overview of spinal arthroplasty surgery to help you feel confident and informed heading into the procedure. 

What is Lumbar Arthroplasty?

Lumbar arthroplasty is a surgical procedure that involves removing and replacing a damaged spinal disc in the lumbar spine. It’s commonly considered a substitute for spinal fusion, which involves fusing two vertebrae into a single bone. 

In lumbar arthroplasty, the damaged spinal disc is replaced with a spinal implant, prosthetic, or artificial disc. There are many different implant options for this procedure, each of which can impact the success of the surgery and your spinal motion.

Later in this article, we’ll discuss spinal implants for lumbar arthroplasty, such as the TOPS spinal implant, in greater depth. 

Lumbar Arthroplasty vs. Spinal Fusion

Both spinal fusion and lumbar arthroplasty can be used to resolve pain from spinal disc damage. However, arthroplasty can preserve motion in the spine, while spinal fusion limits it. 

In spinal fusion, the surgeon removes the damaged spinal disc tissue, much like in lumbar arthroplasty. However, instead of using a spinal implant, the surgeon places bone graft material in between the affected vertebrae. 

In the months following spinal fusion, the vertebrae will fuse and form one bone. This prevents lower back pain, but it also keeps the patient from bending and twisting the fused portion of the spine. 

By using an implant instead of fusion, spinal arthroplasty allows the patient to retain spinal flexibility with lower back pain relief. Plus, the recovery process for lumbar arthroplasty with an implant is much shorter than that of spinal fusion.  

Lumbar Arthroplasty For Degenerative Disc Disease

One of the main applications of lumbar arthroplasty is lumbar degenerative disc disease. With almost 400 million people in the world each year diagnosed with degenerative disc disease, this spinal condition is a prevalent issue among older adults.  

What is Degenerative Disc Disease?

Degenerative disc disease occurs as a result of wear and tear on the spinal discs, typically due to aging. Spinal discs protect the vertebrae against damage by absorbing shock and reducing pressure on the spine. Unfortunately, the aging process can weaken and dry out these discs, often leading to pain and other symptoms. 

The spinal discs consist of fibrous tissue, cartilage, and water. The fibrous tissue makes up each disc’s tough outer layer, called the annulus fibrosus. The interior of each spinal disc is a soft, viscous core called the nucleus.

When spinal discs are undermined by the natural aging process, it can increase your risk of developing spinal conditions, such as osteoarthritis, spinal stenosis, and spondylolisthesis. 

If a degenerated disc in the lumbar spine causes severe and/or chronic back pain, lumbar arthroplasty may be performed to remove the diseased disc. However, lumbar arthroplasty is typically only performed if non-invasive treatments have failed.

Non-Invasive Treatments For Lumbar Disc Disease

Physicians usually recommend non-invasive treatments to relieve symptoms of lumbar disc disease before considering spinal arthroplasty. Examples of non-surgical solutions for disc disease include:

  • Heat and cold therapy

At-home heat and cold therapy can help relieve pain, muscle tension, and inflammation from lumbar disc disease.

Placing an ice pack over the lower back for 10 to 20 minutes can ease inflammation, swelling, and pain. Using a heating pad or taking a warm bath can release tension in the lower back and prevent spasms for pain relief. 

  • Physical therapy 

Physical therapy is one of the most effective non-surgical treatments for disc disease. It often involves strengthening the muscles that support the spine, improving the body’s range of motion, and promoting physical activity to relieve pain. 

  • Pain medications

Over-the-counter pain medications can offer relief from spinal disc disease pain. Generally, OTC pain medications are effective for mild pain and inflammation.

Severe pain typically needs to be treated with prescription pain medications. Additionally, prescription pain medications can generally only be used for a limited period of time, so they’re not a sustainable solution for spinal disc pain. 

  • Epidural steroid injections

Epidural steroid injections can be used to relieve pain and inflammation from a damaged spinal disc. Specifically, steroid injections lower the immune activity in the damaged area of the spine, which reduces inflammatory cell production. 

Usually, epidural steroid injections are the most effective when they’re used in combination with other therapies, such as physical therapy. However, physicians usually only recommend that patients get two to three steroid injections per year. Excessive injections can diminish the condition of the vertebrae and adjacent muscles.

What To Know About Lumbar Arthroplasty Before The Procedure

Before undergoing lumbar arthroplasty to relieve lower back pain, it’s important to understand the surgery preparation, procedure steps, and recovery process. 

Preparing For Lumbar Arthroplasty

To prepare for lumbar arthroplasty, your doctor may ask that you:

  • Quit smoking

Smoking reduces blood flow and adversely affects the function of the heart and lungs. This can lead to breathing issues during surgery and inhibit your healing process. 

  • Stop taking certain medications and/or supplements

Before undergoing lumbar arthroplasty, talk to your doctor about the medications and supplements that you’re currently taking. You may need to stop taking some or all of them before the surgery. 

  • Stop eating and drinking in the hours before the procedure

To ensure that the anesthesia is more predictable, patients are generally asked to stop eating and drinking around 8 hours before the procedure. 

The Steps of Lumbar Arthroplasty Surgery

Spinal arthroplasty generally involves the following steps:

  1. You’ll receive general anesthesia to keep you asleep throughout the procedure. 
  2. The surgeon will make an incision, often in the abdomen, and move aside organs and tissues to gain access to the spine. 
  3. The surgeon will remove the damaged disc. 
  4. An artificial disc/spinal implant will be positioned and secured around the affected vertebrae. 
  5. The surgeon will reposition the organs and tissues, then close the incision to complete the procedure. 

The exact steps of lumbar surgery can depend on a range of factors, including which spinal implant is used. The TOPS System is an innovative spinal implant that has proven to yield positive patient outcomes after lumbar arthroplasty surgery.  

Recovering From Lumbar Arthroplasty

Lumbar arthroplasty doesn’t involve bone healing. So, it has a shorter and less painful recovery period than other spinal procedures, such as spinal fusion. 

With that said, you may still be given pain medications and will need to avoid intense physical activities for several weeks. Your doctor will likely recommend physical therapy to improve spinal flexibility and stability after lumbar arthroplasty. 

Shorten The Recovery Period With TOPS

TOPS is a spinal arthroplasty system that can preserve patients’ range of motion and reduce the recovery period after lumbar arthroplasty surgery. Patients can often return to their favorite activities, including sports, within 4 to 6 weeks of spinal arthroplasty with the TOPS implant.  

To learn more about the TOPS spinal arthroplasty system, reach out to Premia Spine today.