Is a spinal disc replacement better than spine fusion?

Traditional spinal surgery often uses a lumbar fusion procedure to eliminate motion at a spinal joint that has worn out. By fusing the joint, the back pain caused by the worn out joint is often alleviated. Unfortunately, spinal fusion has associated complications, among the most concerning that it can accelerate arthritis of nearby joints. A new treatment called a lumbar disc replacement has been developed to address this problem.

Lumbar disc replacement is similar to other types of joint replacement (such as hip and knee replacements). The concept is similar that the surgeon is removing a damaged joint, and replacing this with a metal and plastic implant.

Which is better? The bottom line is that no one really knows. Lumbar disc replacements are much less commonly performed than fusion procedures. Also, people have only had disc replacements for a few year, so no one really knows how well these implants will hold up over time. Finally, there is not enough data to really know if disc replacements will prevent arthritis of neighboring joints over the years.

Image © Sebastian Kaulitzki