Disc Replacement Better Option for Some Patients With Neck and Lower Back Pain

August 03, 2017

When it comes to disc replacement surgery, there aren’t many surgeons with more experience than Backus’ Michael Halperin, MD.

According to the company that manufactures the prosthetic implant, Mobi-C, Dr. Halperin has performed more disc replacement procedures than any other surgeon in New England.

Disc replacement, which has lower reoperation rates for lower back and neck pain sufferers than the traditional spinal fusion procedure, entails the removal of the painful disc and replacement with a prosthetic implant.  The implant, shaped like an Oreo cookie, is made with two metal plates on the top and bottom and a flexible piece of plastic in the middle.  The plastic allows for full range of motion, unlike traditional fusion which involves forming a rigid connection between the painful disc and the surrounding bone.

“After disc replacement, a patient is able to maintain their normal or near normal range of motion in all planes,” Halperin says. 

In traditional fusion the motion segment that is locked-in by the procedure will often cause accelerated degeneration to the adjacent bone segment as it tries to compensate, leading to further pain and or possible surgery in the future.  The Moby – C artificial disc is FDA approved for surgeons to replace two levels of disc at a time, if needed. 

“And with disc replacement, unlike fusion, we’re not relying on biology for success. Fusion requires that bone grows from one vertebra to another. If that process does not fully take place , failure would result. With an artificial disc replacement, after the implants are inserted, there is no need for a bone growing across the disc space” Halperin says.  “In 10 years I haven’t revised a single artificial disc.”

The procedure takes from 45 minutes to an hour and is done on an outpatient basis. The recovery process is faster than fusion with no brace or collar required and some patients retuning to light work almost immediately. Patients with severe arthritis usually aren’t candidates for disc replacement and would instead be advised to have the traditional fusion procedure to relieve their pain.

“I wouldn’t advise any patient who is eligible for disc replacement to have a fusion,” Halperin says, “The short term and long term results are that good.”

Kenneth Paonessa, MD, and Camille Salame, MD, also perform disc replacement surgery at Backus.