Artificial Disk Replacement (ADR)
Overview
Artificial Disk Replacement (ADR) is a procedure that helps improve lower back pain by replacing a damaged spinal disk 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 disks 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 disk. The “jelly” allows the disk to be flexible and strong. The annulus is the flexible outer ring of the disk 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 Disk Replacement (ADR) is a procedure that helps improve lower back pain. During the procedure, the worn or damaged disk 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
- Diskography
- Computed tomography (CT) scans
- X-rays
SURGICAL PROCEDURES/TREATMENTS
Before your procedure, your Florida Orthopaedic Institute physician will discuss the best disk design for you, as there are many different designs to choose from. In most cases, the disk replacement substitutes for both the annulus and nucleus, with a mechanical device that will simulate spinal function. Disks 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 disk.
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 disk space is then opened and exposed, the problematic disk is removed, and the artificial disk 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
- Anterior Cervical Corpectomy & Discectomy
- Artificial Disk Replacement (ADR)
- Bone Cement Injection
- Degenerative Disk Disease
- Diffuse Idiopathic Skeletal Hyperostosis (DISH)
- Discectomy
- Discitis Treatment & Information
- Epidural Injections for Spinal Pain
- Foraminotomy
- Interlaminar Implants
- Interlaminar Lumbar Instrumental Fusion: ILIF
- Kyphoplasty (Balloon Vertebroplasty)
- Kyphosis
- Laminectomy: Decompression Surgery
- Lumbar Epidural Steroid Injection
- Lumbar Interbody Fusion (IBF)
- Minimally Invasive Spine Surgery
- Outpatient Spine Surgery
- Pinched Nerve
- Piriformis Syndrome
- Sacroiliac Joint Pain
- Sciatica
- Scoliosis
- Spinal Fusion
- Spondylolisthesis and Spondylolysis
- Vertebroplasty
- Whiplash and Whiplash Associated Disorder (WAD)
The following Florida Orthopaedic Institute physicians specialize in Artificial Disk Replacement (ADR):
Specialties
- AC Joint Injuries
- Achilles Tendinitis - Achilles Insertional Calcific Tendinopathy (ACIT)
- Achilles Tendon Rupture
- Achilles Tendonitis
- ACL Injuries
- Ankle Fracture Surgery
- Ankle Fractures (Broken Ankle)
- Ankle Fusion Surgery
- Anterior Cervical Corpectomy & Discectomy
- Arthroscopic Articular Cartilage Repair
- Arthroscopic Chondroplasty
- Arthroscopic Debridement of the Elbow
- Arthroscopy Of the Ankle
- Articular Cartilage Restoration
- Artificial Disk Replacement (ADR)
- Aspiration of the Olecranon Bursa - Fluid In Elbow
- Atraumatic Shoulder Instability
- Avascular Necrosis (Osteonecrosis)
- Bankart Repair
- Basal Joint Surgery
- Bicep Tendon Tear
- Bicep Tenodesis
- Bone Cement Injection
- Bone Growth Stimulation
- Bone Health Clinic
- Broken Collarbone
- Bunions
- Bursitis of the Shoulder (Subacromial Bursitis)
- Calcific Tendinitis of the Shoulder
- Carpal Tunnel Syndrome
- Charcot Joint
- Chiropractic
- Clavicle Fractures
- Colles’ Fractures (Broken Wrist)
- Common Foot Fractures in Athletes
- Community Outreach
- Cubital Tunnel Syndrome
- De Quervain's Tenosynovitis
- Deep Thigh Bruising
- Degenerative Disk Disease
- Diffuse Idiopathic Skeletal Hyperostosis (DISH)
- Discectomy
- Discitis Treatment & Information
- Dislocated Shoulder
- Dupuytren’s Disease
- Elbow
- Elbow Bursitis
- Elbow Injuries & Inner Elbow Pain in Throwing Athletes
- Epidural Injections for Spinal Pain
- Finger Dislocation
- Flexor Tendonitis
- Foot Stress Fractures
- Foot, Ankle & Lower Leg
- Foraminotomy
- Fractured Fingers
- 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
- Groin Strains and Pulls
- Growth Plate Injuries Of The Elbow
- Hallux Rigidus Surgery - Cheilectomy
- Hammer Toe
- Hamstring Injuries
- Hand & Finger Replantation
- Hand & Wrist
- Hand Nerve Decompression
- Hand Skin Grafts
- Hand, Wrist, Elbow & Shoulder
- Heat Injury/Heat Prostration
- High Ankle Sprain (Syndesmosis Ligament Injury)
- Hip & Thigh
- Hip Arthroscopy
- Hip Dislocation
- Hip Flexor Strains
- Hip Fractures
- Hip Hemiarthroplasty
- Hip Impingement Labral Tears
- Hip Muscle Strains
- Hip Pointers and Trochanteric Bursitis
- Hyperextension Injury of the Elbow
- Iliopsoas Tenotomy
- Iliotibial Band Syndrome
- Impingement Syndrome of the Shoulder
- Interlaminar Implants
- Interlaminar Lumbar Instrumental Fusion: ILIF
- Interventional Pain Management
- Interventional Spine
- Intraarticular Calcaneal Fracture
- Joint Replacement
- Knee & Leg
- Kyphoplasty (Balloon Vertebroplasty)
- Kyphosis
- Labral Tears Of The Hip (Acetabular Labrum Tears)
- Laminectomy: Decompression Surgery
- Lateral Collateral Ligament (LCL) Injuries
- Lisfranc Injuries
- Little League Shoulder
- LITTLE LEAGUER'S ELBOW (MEDIAL APOPHYSITIS)
- Lumbar Epidural Steroid Injection
- Lumbar Interbody Fusion (IBF)
- MACI
- Mallet, Hammer & Claw Toes
- Medial Collateral Ligament Injuries
- Meniscus Tears
- Metatarsalgia
- Minimally Invasive Spine Surgery
- Morton’s Neuroma
- Muscle Spasms
- Muscle Strains of The Calf
- Nerve Pain
- Neuromas (Foot)
- Neurosurgery
- Olecranon Stress Fractures
- Orthopaedic Total Wellness
- Orthopedic Physician Or A Podiatrist? Definition of a Podiatrist
- 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
- Piriformis Syndrome
- Piriformis Syndrome
- Plantar Fasciitis
- Podiatry
- Primary Care Sports Medicine
- Quadriceps Tendon Tear
- Radial Tunnel Syndrome (Entrapment of the Radial Nerve)
- Revascularization of the Hand
- Reverse Total Shoulder Replacement
- Rheumatoid Arthritis (RA) of the Shoulder
- Rheumatoid Arthritis Of The Hand
- Robotics
- Rotator Cuff Tears
- Runner's Knee
- Sacroiliac Joint Pain
- Sciatica
- Scoliosis
- Shin Splints
- Shoulder
- Shoulder Arthritis
- Shoulder Arthroscopy
- Shoulder Injury: Pain In The Overhead Athlete
- Shoulder Replacement
- Shoulder Separations
- Shoulder Socket Fracture (Glenoid Fracture)
- SLAP Tears & Repairs
- Spinal Fusion
- Spine
- Spondylolisthesis and Spondylolysis
- Sports Foot Injuries
- Sports Hernias (Athletic Pubalgia)
- Sports Medicine
- Sports Wrist and Hand Injuries
- Sprained Ankle
- Sprained Wrist Symptoms and Treatment
- Subacromial Decompression
- Sudden (Acute) Finger, Hand & Wrist Injuries
- Targeted Muscle Reinnervation (TMR)
- Tendon Transfers of The Hand
- Tennis Elbow Treatment
- Thigh Fractures
- Thigh Muscle Strains
- Thumb Ulnar Collateral Ligament Injuries
- Total Ankle Replacement
- Total Hip Arthroplasty
- Total Hip Replacement - Anterior Approach
- Total Knee Replacement Surgery
- Trapezius Strain (Muscle Strain of The Upper Back)
- Traumatic Shoulder Instability
- Tricep Pain & Tendonitis
- Trigger Finger
- Turf Toe
- UCL (Ulnar Collateral Ligament) Injuries
- Ulnar Neuritis
- Valgus Extension Overload
- Vertebroplasty
- WALANT (Wide Awake Local Anesthesia No Tourniquet)
- Whiplash and Whiplash Associated Disorder (WAD)
- Wound Care
- Wrist Arthroscopy
- Wrist Fractures
- Wrist Tendonitis
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