Artificial Disc Replacement (ADR)
Overview
Artificial Disc Replacement (ADR) is a procedure that helps improve lower back pain by replacing a damaged spinal disc with an artificial one. While the procedure may not completely eliminate pain, within the weeks and months following surgery lower back pain is usually improved without constricting spinal movement.
ANATOMY
The spine consists of 33 individual interlocking bones known as vertebrae. The vertebrae are categorized into five regions:
- Cervical
- Thoracic
- Lumbar
- Sacrum
- Coccyx
The primary function of the vertebrae in the lumbar region of the spine is to bear the weight of the body. To support all that weight, they are larger in size as compared to the other vertebrae.
Intervertebral discs sit between the vertebrae and act as shock absorbers for the spine. They are flat, round and about half an inch thick. They are made up of two components—the nucleus pulposus and the annulus fibrosus. The nucleus has a jelly-like consistency and is found in the center of the disc. The “jelly” allows the disc to be flexible and strong. The annulus is the flexible outer ring of the disc and consists of several layers.
When moving or standing, weight is put on the nucleus, causing it to expand while the annulus holds it in place. Together, the nucleus and annulus allow for movement to take place while simultaneously maintaining the strength of the spine. Many nerve endings surround the annulus and, as a result, an injured annulus can cause pain.
DESCRIPTION
Artificial Disc Replacement (ADR) is a procedure that helps improve lower back pain. During the procedure, the worn or damaged disc material between the small bones in vertebrae in the spine is removed and replaced with a synthetic or “artificial” disk. The goal of the procedure is to relieve back pain while maintaining a normal motion than allowed with some other procedures, such as spinal fusion.
Spinal fusion is a surgical technique that physically joins two or more vertebrae. While many patients are helped by this procedure, the results can vary. It is believed that poor spinal fusion results occur because the procedure prevents normal spine movement. ADR improves on this failure by maintaining a more normal spinal motion, which has been proven to cause better post-surgery results.
DIAGNOSIS
ADR is not meant for everyone. Your Florida Orthopaedic Institute physician will analyze your symptoms, looking for the following:
- Back pain caused by one or two problematic intervertebral disks in the lumbar spine.
- No significant facet joint disease or bony compression on spinal nerves.
- Body size that is not excessively overweight.
- No prior major surgery on the lumbar spine.
- No deformity of the spine (scoliosis).
Your physician may need a few tests to further decide if ADR is right for you. These tests include:
- Magnetic resonance imaging (MRI) scans
- Discography
- Computed tomography (CT) scans
- X-rays
SURGICAL PROCEDURES/TREATMENTS
Before your procedure, your Florida Orthopaedic Institute physician will discuss the best disc design for you, as there are many different designs to choose from. In most cases, the disc replacement substitutes for both the annulus and nucleus, with a mechanical device that will simulate spinal function. Discs can be made of metal (medical grade cobalt, chromium or titanium alloy) or a combination of metal and medical grade plastic (polyethylene). Each design, while all different, maintains a similar goal – to reproduce the size and function of a healthy intervertebral disc.
During the procedure, an incision will be made in your lower back. This incision location means that the organs and blood vessels must be moved to the side, allowing your surgeon to access your spine without moving the nerves. The disc space is then opened and exposed, the problematic disc is removed, and the artificial disc is implanted in its place.
NEXT STEPS
In most cases, patients stay in the hospital for one to three days and are encouraged to stand and walk by the first day after surgery. Basic exercises, including regular walking and stretching, will need to be performed during the first several weeks after surgery to ensure a smooth recovery. During this time, any activities that cause the back to hyperextend should be avoided. Most patients will experience pain improvement in the weeks to months following surgery, but the complete elimination of lower back pain is not a guarantee.
If you are experiencing back pain, contact one of the fellowship trained physicians at Florida Orthopaedic Institute for a consultation.
Areas of Focus
- Spine
- ALIF: Anterior Lumbar Interbody Fusion Surgery
- Artificial Disc Replacement (ADR)
- Back Surgery Types
- Degenerative Disc Disease
- Diffuse Idiopathic Skeletal Hyperostosis (DISH)
- Discitis
- Epidural Injections for Spinal Pain
- Kyphosis
- Minimally Invasive Spine Surgery
- Outpatient Spine Surgery
- Pinched Nerve
- Sciatica
- Scoliosis
- Spinal Fusion
- Spondylolisthesis and Spondylolysis
- Vertebroplasty
- Whiplash and Whiplash Associated Disorder (WAD)
The following Florida Orthopaedic Institute physicians specialize in Artificial Disc Replacement (ADR):
Specialties
- Achilles Tendinitis - Achilles Insertional Calcific Tendinopathy (ACIT)
- Achilles Tendon Rupture
- Achilles Tendonitis
- ACL Injuries
- ALIF: Anterior Lumbar Interbody Fusion Surgery
- Ankle Fracture Surgery
- Ankle Fractures (Broken Ankle)
- Ankle Fusion
- Arthritis & Adult Reconstruction Surgery
- Arthroscopic Chondroplasty
- Arthroscopic Debridement of the Elbow
- Arthroscopic Rotator Cuff Repair
- Artificial Disc Replacement (ADR)
- Aspiration of the Olecranon Bursa
- Avascular Necrosis (Osteonecrosis)
- Back Surgery Types
- Bankart Repair
- Basal Joint Surgery
- Bicep Tendon Tear
- Bicep Tenodesis
- Bioinductive Implant
- Broken Collarbone
- Bunions
- Bursitis of the Shoulder (Subacromial Bursitis)
- Calcific Tendinitis of the Shoulder
- Carpal Tunnel Syndrome
- CARTIVA® Implant For Big Toe Joint Arthritis
- Charcot Joint
- Chiropractic
- Colles’ Fractures (Broken Wrist)
- Community Outreach
- ConforMIS Knee Replacement
- Cubital Tunnel Syndrome
- De Quervain's Tenosynovitis
- Degenerative Disc Disease
- Diffuse Idiopathic Skeletal Hyperostosis (DISH)
- Discitis
- Dislocated Shoulder
- Dupuytren’s Disease
- Elbow
- Elbow Bursitis
- Elbow Injuries in Throwing Athletes
- Epidural Injections for Spinal Pain
- Finger Dislocation
- Flexor Tendonitis
- Foot, Ankle & Lower Leg
- Fractures Of The Shoulder Blade (Scapula)
- Fractures Of The Tibial Spine
- Functional Nerve Transfers of The Hand
- Ganglion Cysts
- General Orthopedics
- Glenoid Labrum Tear
- Golfer's Elbow
- Growth Plate Injuries Of The Elbow
- Hallux Rigidus - Cheilectomy
- Hand & Finger Replantation
- Hand & Upper Extremity
- Hand & Wrist
- Hand Nerve Decompression
- Hand Skin Grafts
- Hip & Thigh
- Hip Arthroscopy
- Hip Dislocation
- Hip Flexor Strains
- Hip Fractures
- Hip Hemiarthroplasty
- Hip Muscle Strains
- Hyperextension Injury of the Elbow
- Iliotibial Band Syndrome
- Interventional Pain Management
- Interventional Spine
- Intraarticular Calcaneal Fracture
- Knee & Leg
- Kyphosis
- Labral Tears Of The Hip (Acetabular Labrum Tears)
- Lateral Collateral Ligament (LCL) Injuries
- Lisfranc Injuries
- LITTLE LEAGUER'S ELBOW (MEDIAL APOPHYSITIS)
- MACI
- MAKO Knee Replacement Surgery
- MAKO Total Hip Replacement
- Mallet, Hammer & Claw Toes
- Medial Collateral Ligament Injuries
- Meniscus Tears
- Metatarsalgia
- Minimally Invasive Spine Surgery
- Morton’s Neuroma
- Muscle Spasms
- NAVIO Surgical System
- Nerve Pain
- Neuromas (Foot)
- Olecranon Stress Fractures
- Orthopaedic Total Wellness
- Orthopedic Trauma
- Osteoarthritis of the Hip
- Osteoporosis
- Outpatient Spine Surgery
- Partial Knee Replacement
- Patellar Fracture
- Pelvic Ring Fractures
- Peripheral Nerve Surgery (Hand) Revision
- Pinched Nerve
- Plantar Fasciitis
- Podiatrist or Orthopaedic Physician?
- Primary Care Orthopedics Sports Medicine
- PROstep™ Minimally Invasive Surgery for Bunions
- Quadriceps Tendon Tear
- Revascularization of the Hand
- Reverse Total Shoulder Replacement
- Revision Knee Surgery
- Rheumatoid Arthritis (RA) of the Shoulder
- Rheumatoid Arthritis Of The Hand
- Robotics
- ROSA® Knee Robotic Surgical Assistant
- Sciatica
- Scoliosis
- Senior Strong
- Shin Splints
- Shoulder
- Shoulder Arthritis
- Shoulder Arthroscopy
- Shoulder Replacement
- Shoulder Socket Fracture (Glenoid Fracture)
- SLAP Tears & Repairs
- Spinal Fusion
- Spine
- Spondylolisthesis and Spondylolysis
- Sports Hernias (Athletic Pubalgia)
- Sports Medicine
- Sprained Ankle
- Sudden (Acute) Finger, Hand & Wrist Injuries
- Targeted Muscle Reinnervation (TMR)
- Tendon Transfers of The Hand
- Tennis Elbow
- Thigh Fractures
- Thigh Muscle Strains
- Total Ankle Replacement
- Total Hip Arthroplasty
- Total Hip Replacement - Anterior Approach
- Total Knee Replacement
- Triceps Tendonitis
- Trigger Finger
- UCL (Ulnar Collateral Ligament) Injuries
- Ulnar Neuritis
- Valgus Extension Overload
- Verilast
- Vertebroplasty
- WALANT (Wide Awake Local Anesthesia No Tourniquet)
- Whiplash and Whiplash Associated Disorder (WAD)
- Wrist Arthroscopy
- Wrist Fractures
- Wrist Sprains
- Wrist Tendonitis