Disc replacement: treating the herniation while preserving movement
Cervical and lumbar disc arthroplasty in Valencia — the alternative to fusion when the case allows it.
For decades, the only surgical solution for an irreparable disc was to fuse the two vertebrae. Disc arthroplasty changed that paradigm: it replaces the damaged disc with an articulated prosthesis that maintains the movement of the segment, similar to a hip or knee replacement.
What does it involve?
Through an anterior approach (in front of the neck in the cervical spine, through the abdomen in the lumbar spine), the damaged disc is removed completely, the compressed nerve structures are freed, and the prosthesis is implanted, anchored to the upper and lower vertebrae. The segment retains flexion, extension and rotation.
Prosthesis vs. fusion: the honest comparison
Mobility
The prosthesis preserves movement; fusion eliminates it at that segment.
Adjacent levels
By maintaining movement, the prosthesis reduces overload of the neighboring discs.
Versatility
Fusion works for almost everything; the prosthesis requires strict anatomical criteria.
Recovery
Both allow fast recovery with minimally invasive technique; the prosthesis usually avoids a brace.
Who is a good candidate?
Symptomatic disc herniation or disc disease at one or two levels, mainly cervical; facet joints in good condition (no advanced arthrosis); no vertebral instability or significant deformity; good bone quality; relatively young, active patients who want to preserve mobility. When these requirements are not met, fusion —or in selected cases an endoscopic decompression without an implant— may be the better option. The correct indication matters more than the fashionable technique.
Recovery
Hospital stay of 1–2 nights, walking the same day or the next, and return to office activity in 2–4 weeks. Guided physiotherapy speeds readaptation. X-ray follow-up checks the position and function of the prosthesis.
Frequently asked questions
The registries with the longest follow-up (especially cervical) show good function at 10–15 years in most patients. As with any implant, it requires correct indication and technique.
No: the goal is precisely a natural movement. Most patients forget they have it.
There is the option of revision or conversion to fusion. This is one of the reasons candidate selection is so strict: to minimize that probability.
Have you been offered a fusion and want to know the alternatives?
Not every case is a candidate for a prosthesis, but it is worth knowing before deciding. Dr. Vilatela reviews your case and explains both options with their real pros and cons.