Knee and hip replacements have been common for decades, offering patients who suffered from degeneration a full range of pain-free movement. But spines and backs have been more problematic. Spinal fusions, the gold standard, have meant a limited range of motion for patients and even future procedures on adjoining discs.

But a newer procedure that involves inserting an artificial disc, called total disc replacement, means patients can get that range of motion and pain relief without the drawbacks of fusion. Once other therapies have been exhausted, Dr. Amiel Bethel, a neurosurgeon at Baltimore Washington Medical Center, performs the procedure through a small incision, minimizing tissue disruption.

Q: How common is such degeneration in the spine and what causes it?

Spine degeneration is an aging process that affects everyone. In the normal aging process, we reach a point in our lives where the amount of tissue being destroyed is more than the amount being produced. The ligaments become weakened. The discs lose water and degenerate. The bones degenerate and form spurs. The joints become less lubricated, the muscles weaken. This all contributes to the degeneration of the spine.

A: What nonsurgical treatments are generally explored?

People try medication to alleviate the pain associated with spine degeneration and a course of physical therapy. Some patients will undergo steroid injections for the degeneration and nerve pain.

Q: What is total disk replacement surgery like and how long is recovery?

A: Total disc replacement is similar to more standard discectomy procedures in its approach. The recovery is usually 6-8 weeks, although the patient has full movement throughout the recovery period.

Q: Why do young people benefit most from the surgery?

A: The surgery has the added benefit of motion preservation at the affected disc, retaining the neck’s full range of motion.

Q: How is it different or better than a spinal fusion?

A: The affected disc, unlike fusion, is no longer a burden to the adjacent discs for movement.