A vertebra (plural vertebrae) is one of the bones that make up the spinal column. Spinal discs are the firm yet pliable structures between the vertebrae. Spinal discs can be replaced with artificial discs, but vertebrae cannot be replaced. In the case of a severe and unstable spinal fracture, a portion of the vertebral bone can be removed and repaired with a metal cage and bone graft material. This is called vertebral body replacement and it is the closest procedure to a vertebra replacement that currently exists.
Understanding the Spine and Vertebrae
Adults have 24 individual vertebral bones that make up the spinal column, plus two bones that are made up of fused vertebrae. There are seven cervical vertebrae located in the neck, twelve thoracic vertebrae in the upper back and five lumbar vertebrae in the lower back. These vertebrae are the largest and support the majority of the body’s weight. Five sacral vertebrae are fused together to form the sacrum, and four others are fused to form the coccyx or tailbone.
Intervertebral discs are found between each pair of vertebrae (except for the very top and very bottom of the spine). These spinal discs act as shock absorbers and provide cushioning between the vertebrae. Each disc consists of a tough outer ring called the annulus fibrosus and a gel-like inner core called the nucleus pulposus.
The spinal cord, the bundle of nerves and nerve cells that send signals to and from the brain, runs within the spine. The body of the vertebral bone is the thick, rounded, front anterior portion. It supports the weight of the body and transmits forces to the adjacent vertebrae. The spinal disc lives between vertebral bodies. The center of the vertebra made up of two pedicles and two laminae, surrounds the spinal cord. Lastly, the back of the spinal bone is made up of several processes and facets, i.e., bony protrusions and places where the bones meet.
The spine provides structural support to the body and protects the spinal cord. The spine’s alternating structure of spinal bone and spinal disc provides both stability and flexibility of the spine, allowing us to bend, twist, and stretch.
The spine can be affected by numerous conditions including arthritis, degenerative disc disease, disc herniation, spinal stenosis, and muscle strain.
Traditional Treatments for Spinal Conditions
Fortunately, most cases of neck and low back pain will go away with time and conservative treatments. That said, if your neck or back pain does not resolve within about four weeks (or if it is severe), contact Dr. Lanman for diagnosis and treatment options.
Non-surgical Approaches
Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, are often prescribed to manage pain and reduce inflammation associated with spinal conditions. Muscle relaxants may be used to alleviate muscle spasms. In some cases, oral or injectable corticosteroids may be recommended to provide short-term relief for acute flare-ups.
Physical therapy is frequently used to improve strength, flexibility, and posture, and to relieve pain and promote functional recovery. Therapeutic exercises, stretches, manual therapy techniques, and other modalities like heat or ice may be utilized to target specific spinal conditions.
In some cases, anti-inflammatory (corticosteroid) medication can be injected directly into the affected area to reduce pain and inflammation. In cases where conservative measures do not provide sufficient relief, pain management techniques may be considered. These include transcutaneous electrical nerve stimulation (TENS), ultrasound therapy, acupuncture, or radiofrequency ablation.
Over the long term, maintaining a healthy weight, adopting proper body mechanics, avoiding heavy lifting, and improving ergonomics at work or home can significantly help relieve and prevent some spinal conditions.
Surgical Interventions
Less than 10% of patients with neck or low back pain will need surgery, but for those who do, there are a few options.
Spinal Fusion
Spinal fusion surgery is a procedure to join two or more vertebrae together permanently. The spinal disc is removed along with any portions that may have leaked out to surrounding areas. A cage and artificial bone material is placed in the space between the vertebrae. Over time the spinal bones should knit together, forming a solid fusion. Removing the natural disc relieves pain, and the fusion provides strength and stability.
Artificial Disc Replacement
Artificial disc replacement is a spine surgery procedure in which the spinal disc is completely removed (along with any portions that may have leaked out to surrounding areas) and medical implant is placed between the vertebrae. Removing the natural disc relieves pain, and the artificial disc provides the strength, height, stability, and mobility to the spine.
Spinal Decompression
Surgical spinal decompression is a procedure to remove the structures compressing the spinal cord or nerves. Depending on the specific condition, the surgical procedure may include one or more of the following techniques:
Discectomy: Removal of a portion or the entire herniated or degenerated disc that is pressing on the nerve.
Laminectomy: Removal of the lamina, a part of the vertebral arch, to create more space for the spinal cord and nerve roots.
Foraminotomy: Enlargement of the intervertebral foramen, the passageway through which spinal nerves exit the spinal canal, to relieve nerve compression.
Corpectomy: Removal of a portion of the vertebral body, usually performed for more severe cases of spinal compression due to fractures or tumors.
A Vertebra Cannot Be Replaced, But Here’s What Can Help
While spine surgeons cannot remove an entire vertebra, they can relieve neck and low back pain. Spine surgeons are spine pain experts; Dr. Lanman can help relieve spine pain with a combination of conservative and surgical treatments that is individualized to your needs. If you need spine surgery and are a candidate for artificial disc replacement, you should strongly consider it.
Benefits of Disc Replacement Procedures
Like spinal fusion, artificial disc replacement relieves chronic neck or low back pain. However, artificial disc replacement allows patients to avoid having their spinal bones fused together. Spinal bones were meant to move independently from one another—this is what gives the spine flexibility and mobility. Artificial disc replacement not only relieves pain but it also restores spinal mobility.
Potential Risks and Complications of Disc Replacement
As with any surgery, there are certain risks of disc replacement surgery. Fortunately, in skilled hands, these complications are rare. General risks associated with surgery include infection, bleeding, anesthesia reactions, blood clots, nerve injury or blood vessel injury. Risks specific to artificial disc replacement include device displacement, adjacent segment degeneration, or allergic reaction to part of the implant. Make sure you understand your risks and alternatives before consenting to any medical or surgical procedure.
Conclusion
Can vertebrae be replaced? No, they cannot. But the spinal discs are often the source of chronic neck and low back pain, and spinal discs can be replaced. If you are experiencing chronic neck or low back pain, make an appointment to see Dr. Lanman. He is not only one of the world’s leading experts in artificial disc replacement, but he has helped countless patients find relief from pain and improved spinal mobility.
Frequently Asked Questions
How long is recovery from vertebrae surgery?
Recovery from vertebral body replacement surgery can take several months to a year. Spinal fusion surgery recovery takes several months. Recovery from artificial disc replacement is the fastest, usually taking a matter of weeks.
Can you get an artificial vertebrae?
No, you cannot get an artificial vertebra, but you can get an artificial spinal disc.
How long does an artificial disc last?
In laboratory tested (accelerated wear testing), artificial discs last 50 to 100 years. After having an artificial disc replacement, most patients will not need to have the artificial disc replaced again.
Who is not a candidate for disc replacement?
Most patients can have artificial disc replacement, but some cannot. Patients with spinal fractures, cancer of the spine, osteoporosis of the spine, or facet joint disease are not candidates for artificial disc replacement.
Is disc replacement better than fusion?
For most people, yes, artificial disc replacement is better than fusion. Both procedures relief pain and symptoms of degenerative disc disease, but artificial disc replacement has several advantages over spinal fusion: recovery is faster after artificial disc replacement and the spine has greater flexibility and mobility compared to fusion.
