Artificial Spine Disc Replacement Treatment Cost in India

In this kind of surgery, a damaged or worn out disc material found between the vertebrae or the small bones making the spine is removed. The removed disc is replaced with an artificial disc that is synthetic in nature. The aim of the surgery is to relieve the patient from the back pain and also bring about and restore normal motion, which may be something that cannot be achieved with spinal fusion surgery.

Spine in the body helps in maintaining the posture of the body and at the same time allows mobility in different directions. It also houses the spinal cord. This is made of small bones called the vertebrae. When this wears out then the spine is unable to continue its function and as a result back pain occurs. Largely such cases can be dealt with medicines, physiotherapy or pain killers but some small percentage may require surgery if the patient is showing signs of no improvement in spite of continuous non-operative treatment for more than 6 weeks.

The doctor will diagnose the patient carefully whether he or she is a good candidate for disc replacement or not by doing the following tests

•           MRI (Magnetic resonance imaging) scans
•           CT (Computed tomography) scans
•           Discography
•           X-rays

From these tests the doctor will also be able to find out the sources of the back pain. In certain cases, as given below this kind of surgery is not recommended.

•         Two or more problematic intervertebral discs in the lumbar region causing the back pain
•          Scoliosis condition ( deformation of the spine)
•          No major surgery conducted on the lumbar spine
•          Overweight person
•         Bony compression on spinal nerves or any significant facet joint disease

Artificial disks or disk prosthesis is a device that can mostly be divided into two types: complete replacement of the disks and replacement of the nuclei.  In the first type most or entire disc tissue is replaced by a new system that is inserted into the vertebrae void. The core or nucleus of the disk is only removed with the second kind and replaced by the implant. In this case, it does not detach the annulus or the outer portion.

These discs are usually made of biopolymers or metal kind. In some cases, they are made of both types. The design of the disc includes two plates; one attaches to the vertebra which is above the disc being replaced and the second is attached to the vertebra positioned below.  In some devices, there is a soft compressible plastic like a piece present. Motion is possible due to the curved surfaces gliding smoothly over each other.

In the nucleus type also biopolymers are used and one such substance is called hydrogel.  This substance absorbs water and the material expands. In the nuclear cavity, the device is kept and it gets hydrated and then fills the cavity. Since this device is compressible, hence it allows motion like the normal nucleus.

General anesthesia is used for disc replacement surgery.  During the surgery, the patient is made to breathe with the assistance of a ventilator and an endotracheal tube is placed for that.  Intravenous antibiotics are administered before the surgery. 

The patient is made to lie on their back on a radiolucent operating table. Now the abdominal area is cleaned and sterilized with a cleaning solution. Sterile drapes are positioned and the team wears sterile surgical aprons to ensure an infection-free environment.

A 3-8 cm oblique or transverse incision is made on the left of the belly button or umbilicus (depending on the number of discs that are to be replaced).  Without cutting the abdominal muscles they are just gently spread away.  The intestine containing peritoneal sac is moved to one side and even the large and major blood vessels are positioned aside.

In order to aid the surgeon to view the anterior aspect of the intervertebral discs, special retractors are employed.  Next, the correct spinal level(s) are identified with the help of an x-ray after getting the retractor in place.

With the help of grasping and special biting instruments like Kerrison rongeur, pituitary rongeur or curettes the intervertebral disc is then removed.  To restore the normal height of the disc and determine the suitable size of the artificial disc replacement that must be implanted special distractor is employed. In the disc space now the artificial disc prosthesis is cautiously placed. To determine whether the prosthesis has been placed correctly a Fluoroscopic x-rays test is taken.

With antibiotics, the wound area is cleaned. With the help of strong sutures, the deep fascial layer and the subcutaneous layers are closed.  With the help of special surgical glue, the incision point over the skin is closed leaving a very minor scar behind.

The surgery time ranges between two to three hours depending on the number of discs to be replaced.

The patient is asked to stay in the hospital for a few days after the surgery is completed. The recovery period is shorter in this case since it does not require a bone to heal. After the surgery, the IV and the bladder catheter will be withdrawn. A brace may be given to the patient depending on the condition and the patient will be advised on some exercise and ways of walking.

The recovery period can stretch from a few weeks to a few months as well. Certain activities may be strictly prohibited for the patient. The patient is expected to keep their incision regions clean, check for signs like swelling or bleeding and must report to their healthcare provider immediately.

Other alternative treatments for back pain can include fusion, noninvasive treatments or no treatment at all.  If the pain has been persistent for quite some months, and the patient has been made to undergo physical therapy, activity modifications, spinal manipulation or injections then only surgery is considered.

Disc replacement surgery costs can vary depending on lumbar disc replacement surgery cost or disc nucleus replacement cost. But as such in India artificial disc replacement cost is significantly low. Disc replacement surgery cost can vary from $5500 to $7500 which is less than even half the cost that may be incurred in the USA with similar amenities and quality of treatment.