As an alternative to spinal fusion, your surgeon may offer a total disc replacement (TDR) for relief of your back and leg pain. A TDR procedure involves removing the degenerated disc and replacing it with an artificial disc implant. After the implant has been inserted between the vertebral bodies, normal disc height is restored and motion in the joint is preserved. This intervertebral joint motion is thought to create "normal balance and a more natural spinal function." It is also theorized that the artificial disc slows down degeneration of adjacent spinal segments. This all sounds great until you examine some of the critical details of how the disc works in practice.
Most complications in TDR surgery occur as the result of inaccurate positioning of the artificial disc. If the surgeon selects too large an implant and places it too far forward in the disc space, the entire implant tends to migrate farther forward, well beyond the the margin of all the other spinal discs. (Migration is the movement or shift in position of an object within the body. It's a constant risk with any implant.) This forward position of the implant can puncture the large blood vessel that lies directly in front of the lumbar spine. The possibility of this one, life-threatening complication is enough to make you think twice about having an artificial disc implanted.
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