Lumbar Disc Replacement
Motion-Preserving Surgery for Degenerative Disc Disease and Discogenic Low Back Pain.
For carefully selected patients with chronic low back pain caused by a damaged lumbar disc, lumbar disc replacement offers a motion-preserving alternative to fusion. NASPI's board-certified spine surgeons perform this advanced procedure using FDA-approved artificial disc implants, close to home in Northern New Jersey.
Medically reviewed by Dr. Daniel M. Dorri, MD, and Dr. Christopher J. Bilbao, DO, Board-Certified Spine Surgeons
Need a Lumbar Disc Replacement?
If chronic low back pain from a damaged lumbar disc has limited your life and conservative treatment has not provided relief, lumbar disc replacement may offer the motion-preserving alternative to lumbar spinal fusion you are looking for. Practice founder Dr. Daniel M. Dorri and fellowship-trained neurosurgeon Dr. Christopher J. Bilbao perform lumbar disc replacement using FDA-approved artificial disc implants at NASPI's Northern New Jersey locations. Expert spine surgery close to home.
What Is Lumbar Disc Replacement?
Lumbar disc replacement, also called lumbar total disc arthroplasty, is a surgical procedure that removes a damaged lumbar disc and replaces it with an FDA-approved artificial disc implant. It is a motion-preserving alternative to lumbar spinal fusion for carefully selected patients with single-level disc disease and primarily discogenic back pain.
The procedure is performed through an anterior retroperitoneal approach, meaning the surgeon accesses the front of the spine through a small incision in the lower abdomen. Because the major blood vessels run in front of the lumbar spine, an access surgeon (typically a vascular surgeon) works alongside your spine surgeon to safely mobilize the vessels and expose the disc space. The damaged disc is removed completely, and a precisely sized artificial disc implant is placed in the cleared space.
Unlike lumbar fusion, which permanently joins vertebrae together and eliminates motion at the treated level, lumbar disc replacement preserves natural spine movement. This may reduce the long-term stress placed on adjacent spinal levels, potentially lowering the risk of adjacent segment disease over time. FDA-approved lumbar disc implants include activL and ProDisc-L, each backed by multi-year clinical trial data demonstrating outcomes equal to or better than fusion in appropriately selected patients.
Conditions Treated With Lumbar Disc Replacement
Lumbar disc replacement is reserved for specific lumbar disc conditions in patients who meet strict FDA candidacy criteria. The procedure is most effective when the disc itself is the primary pain generator and the rest of the spine is relatively healthy.
- $Lumbar Herniated Disc
- $Cervical Herniated Disc
- $Sciatica / Radiculopathy
- $Cervical Radiculopathy
- $Recurrent Disc Herniation
- $Chronic Back or Leg Pain
If conservative treatments like physical therapy, anti-inflammatory medications, and epidural steroid injections have not provided lasting relief, and your imaging confirms single-level disc disease, lumbar disc replacement may be an option. Your surgeon will determine whether you are a candidate for disc replacement or whether lumbar fusion is more appropriate.
Benefits of Lumbar Disc Replacement
Lumbar disc replacement was developed as a motion-preserving alternative to lumbar fusion. For appropriately selected patients, it offers meaningful advantages over traditional fusion in both recovery and long-term outcomes:
Motion Preserved
Natural spine movement maintained.
No Back Muscle Cutting
Anterior approach spares back muscles.
No Fusion Required
Avoids permanent joining of vertebrae.
Reduced Adjacent Stress
May protect neighboring spinal levels.
Faster Than Fusion
Quicker recovery vs. lumbar fusion.
FDA-Approved Devices
Backed by multi-year clinical trial data.
Ready to explore your options?
How Lumbar Disc Replacement Works: What to Expect
Lumbar disc replacement is a major procedure performed by a coordinated surgical team using an anterior abdominal approach. Most patients spend 2 to 3 days in the hospital, with recovery typically faster than lumbar fusion. Here is what to expect from your initial consultation through full recovery.
Before
Before the Procedure
During your initial consultation, your spine surgeon will perform a comprehensive evaluation including lumbar MRI, X-rays with flexion-extension views to assess motion and stability, and additional studies such as discography in select cases to confirm the disc is the primary pain generator. Candidacy for lumbar disc replacement is significantly more selective than for cervical disc replacement because of strict FDA criteria designed to ensure the best outcomes.
You will receive detailed pre-operative instructions covering medications to stop, fasting requirements, what to bring to the hospital, and how to prepare your home for recovery. Because the anterior approach is used, you will also be evaluated by an access surgeon (typically a vascular surgeon) who will assist with safe exposure of the spine during your procedure.
During
During the Procedure
Lumbar disc replacement is performed under general anesthesia using an anterior retroperitoneal approach. A small incision is made on the lower abdomen, and an access surgeon (typically a vascular surgeon) gently mobilizes the major blood vessels to expose the front of the lumbar spine. This team-based approach minimizes risk and shortens operative time.
Your spine surgeon then removes the damaged disc completely. Once the disc space is fully prepared, the artificial lumbar disc implant is precisely sized and placed in the cleared space. The implant restores normal disc height and is designed to allow natural spine motion. The blood vessels are returned to their original position, and the incision is closed in layers.
A single-level lumbar disc replacement typically takes 2 to 3 hours. The combined spine and vascular surgical team ensures safe access to the spine and efficient implant placement.
After
After the Procedure
Most patients spend 2 to 3 days in the hospital after lumbar disc replacement. Walking is encouraged within hours of surgery, which helps with recovery and reduces the risk of complications like blood clots. A back brace is typically not required since the implant provides immediate stability and there is no fusion to protect.
Light activities resume within 1 to 2 weeks. Most patients return to desk work within 2 to 4 weeks. Heavy lifting and physically demanding activities are restricted for several weeks. Because there is no fusion process to wait for, recovery is typically faster than after lumbar fusion. Dr. Dorri, Dr. Bilbao, and their team will provide personalized recovery instructions and recommend physical therapy when appropriate, usually around 4 to 6 weeks after surgery.
Long-term clinical follow-up has shown that patients with lumbar disc replacement often regain significant range of motion at the operated level, and outcomes are equal to or better than lumbar fusion in carefully selected patients.
Are You a Good Candidate?
You may be a candidate if:
- NSingle-level lumbar disc disease confirmed on MRI
- NPrimarily discogenic (disc-source) back pain
- NFailed at least 6 months of conservative care
- NHealthy facet joints at the affected level
- NNo significant spinal instability or deformity
- NGood overall health and bone quality
May not be ideal if:
- Multi-level disease requiring fusion
- Significant facet joint arthritis
- Spondylolisthesis or spinal instability
- Osteoporosis or poor bone quality
- Prior major abdominal surgery limiting anterior access
Every patient is different. During your consultation, your surgeon will perform a thorough evaluation and always recommend the safest, most effective treatment plan for your specific condition, whether that is lumbar disc replacement, lumbar fusion, or continued conservative care.
Risks & What You Should Know
Lumbar disc replacement has an established safety record supported by years of FDA clinical trial data, but as a major surgery involving the anterior approach to the lumbar spine, it carries specific risks, including:
- Vascular injury during anterior approach (rare with experienced access team)
- Retrograde ejaculation in male patients (related to sympathetic nerve disruption)
- Implant migration or settling
- Heterotopic ossification (bone growth that may limit motion)
- Implant wear over time (modern devices designed for long durability)
- Need for revision surgery in rare cases
- Infection at the surgical site
- Persistent or incomplete pain relief
- Standard surgical risks (anesthesia, blood clots)
At NASPI, careful patient selection per FDA candidacy criteria, a coordinated spine and vascular surgical team, and experience with multiple artificial disc devices all work to minimize these risks and give every patient the best possible outcome.
Ready to explore your options?
Your Spine Surgery Team
Daniel M. Dorri, MD, FABPMR
Practice Founder & Spine Surgeon
Dr. Dorri founded NASPI to provide comprehensive spine care from diagnosis through surgical treatment, all under one roof. His extensive experience means your care is guided by a surgeon who has evaluated your condition from day one.
Christopher J. Bilbao, DO,
Board-Certified Neurosurgeon
Dr. Bilbao is a fellowship-trained neurosurgeon with specialized expertise in minimally invasive and endoscopic spine surgery techniques, including robotic-assisted procedures.
Why Choose NASPI for Spine Surgery?
Experienced Surgeons
Advanced motion-preserving lumbar surgery training
Complete Care
Diagnosis through recovery, one roof
Cutting-edge Tech
Latest instruments and imaging
Patient-centered
Clear communication, every step
Lumbar Disc Replacement FAQs
What is the difference between lumbar disc replacement and lumbar spinal fusion?
Both procedures address the same lumbar disc problems, but they take very different approaches. Lumbar spinal fusion permanently joins two or more vertebrae together using bone graft, an interbody cage, and titanium screws and rods. Motion at the fused level is eliminated. Lumbar disc replacement removes the damaged disc and replaces it with an FDA-approved artificial disc that preserves natural motion. Fusion applies to a wider range of conditions including instability and multi-level disease, while disc replacement is reserved for carefully selected patients with single-level discogenic pain.
How long does lumbar disc replacement take?
A single-level lumbar disc replacement typically takes 2 to 3 hours. The coordinated spine and vascular surgical team works efficiently to expose the spine, remove the damaged disc, and place the artificial disc implant.
What is the recovery time after lumbar disc replacement?
Initial recovery requires 2 to 3 days in the hospital. Most patients return to desk work within 2 to 4 weeks. Heavy lifting and physically demanding activities are restricted for several weeks. Because there is no fusion process to wait for, recovery is typically faster than after lumbar fusion. Long-term outcomes are equal to or better than fusion in carefully selected patients.
Why does lumbar disc replacement use an anterior approach?
The anterior approach (through the lower abdomen) provides direct access to the front of the lumbar disc without disrupting the back muscles, facet joints, or spinal nerves. This approach allows for complete disc removal and precise implant placement. Because the major blood vessels pass in front of the lumbar spine, an access surgeon (typically a vascular surgeon) works alongside your spine surgeon to safely mobilize the vessels and expose the disc space. This team-based approach is standard for lumbar disc replacement and is performed routinely at major spine centers.
How long will the artificial disc last?
Modern lumbar disc implants are designed for long-term durability and tested in laboratory conditions to last well over 40 years of normal use. Long-term clinical follow-up of 10 or more years has shown excellent durability with low revision rates. Like any implant, however, very long-term outcomes are still being studied.
Am I a candidate for lumbar disc replacement or do I need fusion?
Lumbar disc replacement has strict FDA-approved candidacy criteria. Ideal candidates typically have single-level disease, primarily discogenic pain (the disc itself is the pain source), healthy facet joints, no significant instability or deformity, good bone quality, and have failed at least 6 months of conservative care. Patients with multi-level disease, significant facet arthritis, spondylolisthesis, osteoporosis, or prior major abdominal surgery are usually better served by lumbar spinal fusion. Your surgeon will evaluate your imaging and overall health to recommend the right procedure.
What artificial disc devices does NASPI use for the lumbar spine?
NASPI surgeons are experienced with FDA-approved lumbar disc implants including activL and ProDisc-L. Each device has specific design features and FDA approvals (single-level versus two-level, lumbar levels covered). Your surgeon will recommend the device best suited to your anatomy, level of disease, and individual factors based on your imaging and intraoperative findings.
Will I need physical therapy after lumbar disc replacement?
Yes. A structured physical therapy program typically starts 4 to 6 weeks after surgery, once your surgeon clears it. PT helps restore spine mobility, rebuild core and back strength, and protect the implant. Because motion is preserved at the operated level, range of motion exercises can be incorporated earlier than after lumbar fusion. Your surgeon will provide personalized PT recommendations.
Is lumbar disc replacement covered by insurance?
Yes, lumbar disc replacement is covered by most major insurance plans when medically necessary and strict FDA candidacy criteria are met. Pre-authorization is required and typically involves documentation of failed conservative care, imaging confirming single-level disease, and specific clinical criteria. Our team will work with you to verify benefits and obtain pre-authorization before scheduling. Contact us with any insurance questions.
Where can I get lumbar disc replacement in Northern New Jersey?
NASPI offers lumbar disc replacement at our Northern New Jersey locations, including Paramus, Clifton, Bayonne, North Bergen, Newark, and Secaucus. Contact us or call (844) 666-2774 to schedule a consultation with Dr. Dorri or Dr. Bilbao.
Related Spine Surgery Procedures
Lumbar Microdiscectomy →
Minimally invasive option for disc herniations not suited to the endoscopic approach.
Endoscopic Discectomy →
Ultra-minimally invasive option for select lumbar herniated discs and sciatica.
Lumbar Spinal Fusion →
For spinal instability, spondylolisthesis, or recurrent herniations requiring stabilization.
Cervical Disc Replacement →
Motion-preserving alternative to fusion for cervical disc disease.
What Our Spine Surgery Patients Are Saying
I found Dr. Dorri to be very detailed and complete in my surgical and follow up appointments.
He always asked how I felt and my concerns very detailed in listening to my concerns and always took time to listen to me.
I've completed my care plan with Dr. Dorri and I'm pleased with the my care and results.
Thank You Dr. Dorri
N. Hairston
I’m truly happy with the results of my surgery. My knee feels so much better, my mobility has improved, and I’m able to do things again that had become difficult before. The improvement has made a real difference in my everyday life.
What I appreciated most was not only Dr. Boiardo’s skill as a surgeon, but also the kindness and personal attention I received throughout the process. I felt that I was in very capable hands every step of the way.
I would highly recommend Dr. Boiardo to anyone needing an orthopedic surgeon. I’m very thankful for the excellent care I received and for such a positive outcome.
Insurance & Locations
NASPI accepts out-of-network benefits from most major insurance plans including Horizon BCBS, Aetna, Cigna, United Healthcare, Oxford, and more.
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We also work with workers' compensation and personal injury/no-fault cases.
*We are unable to accept Medicare, Medicaid, or OMNIA plans at this time.