Artificial Disc Replacement
| CPT |
Technique |
| Indications |
Complications |
| Contraindications |
Follow-up Care |
| Alternatives |
Outcomes |
| Pre-op Planning / Special Considerations |
Review References |
synonyms: total disc replacement
CPT
Anatomy
Indications
- Severe, chronic discogenic low back pain in young motivated patient: positive diskograms, healthy facet joints (CT)
- Recurrent HNP
- Degenerative disc disease above a previously fused segment.
Contraindications
- Central stenosis, severe facet arthritis, degenerative spondylolisthesis
- Lytic Spondylolisthesis
- Scoliosis
- Kyphosis
- Osteoporosis
- Obesity
- Anxiety
- Vascular disease
- Previous back surgery
Alternatives
- Arthrodesis: 27% of arthrodesis patients will have adjacent segment disease requiring surgery at 6.7yrs (Ghiselli G, JBJS 2004;86A1497).
Planning / Special Considerations
Technique
- Sign operative site.
- Pre-operative antibiotics, +/- regional block.
- General endotracheal anesthesia
- position. All bony prominences well padded.
- Examination under anesthesia.
- Prep and drape in standard sterile fashion.
- Irrigate.
- Close in layers.
Complications
Follow-up care
- Post-op:
- 7-10 Days:
- 6 Weeks:
- 3 Months:
- 6 Months:
- 1Yr:
Outcomes
Review References
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