Total Disc Replacement for Chronic Neck and Back Pain

A Motion-Preserving Alternative to Spinal Fusion

Written by: Dean C. Perfetti, MD, MPH, Fellowship-Trained Orthopaedic Spine Surgeon
Reviewed by: Centinel Spine

Inside this Blog: Total Disc Replacement may be an option for some patients with chronic neck or back pain.

• Total Disc Replacement removes a damaged spinal disc and replaces it with an artificial disc
• Unlike spinal fusion, the procedure is designed to help preserve movement in the spine
• Dr. Dean Perfetti performs both cervical and lumbar disc replacement procedures in New York and Connecticut
• Adults may qualify based on FDA-approved indications
• Some patients with annular tears, degenerative disc disease, or chronic disc-related pain may be candidates for evaluation

Chronic neck or back pain can affect nearly every part of daily life. For some people, symptoms may make it harder to sleep comfortably, stay active, sit for long periods, work, exercise, or enjoy normal routines.

In some cases, pain begins when a spinal disc becomes damaged or starts to wear down over time. While spinal fusion surgery has traditionally been used to treat certain spine conditions, some patients may qualify for another option called Total Disc Replacement.

Instead of permanently joining bones together, Total Disc Replacement replaces the damaged disc with an artificial disc designed to help preserve movement in the spine. At Somers Orthopaedic Surgery & Sports Medicine Group, Dr. Dean Perfetti performs cervical and lumbar Total Disc Replacement procedures for qualified patients throughout New York and Connecticut using the Centinel Spine prodisc® platform.

Dr. Perfetti is one of the few spine surgeons in the New York and Connecticut region performing both cervical and lumbar motion-preserving disc replacement procedures.

What Does a Spinal Disc Do?

Spinal discs are soft cushions located between the bones of the spine. They work like shock absorbers, helping the body bend, twist, walk, and move more comfortably throughout the day.

When a disc becomes damaged, worn down, or develops a tear, it may stop absorbing movement properly. This can lead to pain, stiffness, inflammation, or pressure on nearby nerves.

Disc-related pain may be associated with conditions such as degenerative disc disease, annular tears, herniated discs, or other cervical and lumbar spine conditions.

Common Symptoms of Disc Problems

• Chronic neck pain
• Chronic lower back pain
• Pain when sitting, bending, standing, or walking
• Reduced flexibility or stiffness
• Tingling, numbness, or weakness in the arms or legs

Many patients first try physical therapy, medications, injections, or activity modification before considering surgery. When symptoms continue despite conservative care, some patients begin exploring alternatives to spinal fusion.

What Is Total Disc Replacement?

Total Disc Replacement, also called artificial disc replacement, is a type of spine surgery that removes a damaged spinal disc and replaces it with an artificial implant.

The goal of the procedure is to treat disc-related pain while helping maintain more natural movement in the spine. Because of this, Total Disc Replacement is often described as a motion-preserving spine surgery.

In a traditional spinal fusion, two vertebrae are permanently joined together to stabilize part of the spine. Although fusion may still be appropriate for certain conditions, it also limits movement at the treated level.

Total Disc Replacement works differently. Instead of eliminating movement, the artificial disc is designed to support continued motion in the spine when appropriate.

As Dr. Perfetti explains, “Motion matters. The spine wants motion.”

For some patients, preserving movement may also help reduce added stress on nearby spinal levels over time. However, not every patient is a candidate for Total Disc Replacement, and treatment recommendations depend on the patient’s condition, imaging findings, symptoms, and overall spinal health.

How Is Total Disc Replacement Different From Spinal Fusion?

Patients researching treatment options for chronic neck or lower back pain often want to understand how Total Disc Replacement compares to spinal fusion surgery.

Total Disc Replacement vs. Spinal Fusion Comparison

For some patients looking into treatment for back pain without fusion surgery, preserving movement may be an important part of treatment planning. However, spinal fusion may still be the most appropriate option depending on the condition being treated.

Every spine condition is different, which is why a complete evaluation is important before discussing surgical options.

Who May Be a Candidate for Total Disc Replacement?

Some patients with chronic disc-related neck or back pain may qualify for Total Disc Replacement if conservative treatment has not provided enough improvement. In many cases, patients considering this procedure have already tried treatments such as physical therapy, medications, injections, rest, or activity modification without lasting relief.

According to Dr. Perfetti, patients with annular tears or ongoing disc-related pain may be candidates depending on their symptoms, imaging findings, spinal stability, and overall health.

Determining whether a patient qualifies for cervical or lumbar Total Disc Replacement usually begins with a comprehensive spine evaluation. During this process, Dr. Perfetti reviews the patient’s medical history, symptoms, imaging studies, spinal alignment, range of motion, nerve involvement, and prior treatments to better understand the source of pain and whether a motion-preserving procedure may be appropriate.

Because every spine condition is different, treatment recommendations are highly individualized. Factors such as the location of the damaged disc, the overall stability of the spine, age, activity level, and long-term goals all play a role in determining whether artificial disc replacement may be considered.

Patients Who May Qualify for Evaluation

• Adults may qualify based on FDA-approved indications
• Patients with chronic disc-related neck or back pain
• Patients exploring alternatives to spinal fusion surgery
• Patients whose symptoms continue despite conservative treatment

Not every patient is a candidate for artificial disc replacement. Some patients may still benefit more from spinal fusion or another type of spine treatment depending on their condition and overall spinal health.

Cervical and Lumbar Disc Replacement Procedures

Dr. Perfetti performs both cervical disc replacement for the neck and lumbar disc replacement for the lower back. These procedures are designed to treat damaged discs while helping preserve movement in the spine when appropriate.

Cervical disc replacement may be considered for certain patients experiencing neck pain, arm pain, numbness, or disc-related nerve symptoms in the cervical spine.

Lumbar disc replacement may be considered for some patients experiencing chronic lower back pain linked to damaged lumbar discs.

Dr. Perfetti is one of the few spine surgeons in the region performing both cervical and lumbar Total Disc Replacement procedures.

How Does Somers Orthopaedics Use the Centinel Spine prodisc® Platform?

At Somers Orthopaedics, Dr. Perfetti uses the Centinel Spine prodisc® platform as part of a motion-preserving approach to cervical and lumbar spine care.

The prodisc® platform has been studied in published spine research involving both cervical and lumbar Total Disc Replacement. Centinel Spine currently offers FDA-approved Total Disc Replacement systems for two-level use in both the cervical and lumbar spine.

Advanced motion-preserving spine care is not widely available throughout the Hudson Valley and Western Connecticut region. Dr. Perfetti is one of the few spine surgeons in the area performing both cervical and lumbar Total Disc Replacement for qualified patients.

The focus at Somers Orthopaedics is not simply the technology itself, but selecting the right treatment approach for each patient based on anatomy, imaging findings, symptoms, lifestyle, and long-term goals.

Why Are More Patients Exploring Alternatives to Spinal Fusion?

Patients dealing with chronic neck or lower back pain often want to understand every available treatment option before making decisions about surgery.

For some people, concerns about movement after fusion surgery lead them to ask about cervical disc replacement, lumbar disc replacement, or artificial disc replacement. Others may be looking for treatment options that help preserve movement in the spine when medically appropriate.

Total Disc Replacement may be considered for certain patients when preserving spinal motion is an important part of treatment planning. However, the decision between spinal fusion and disc replacement depends on many factors, including spinal stability, disc damage, symptoms, and overall health.

Because every patient’s spine condition is different, treatment recommendations should always be based on a complete evaluation by a qualified spine specialist.

About Dean C. Perfetti, MD, MPH

Dean C. Perfetti, MD, MPH, is a fellowship-trained Orthopaedic Spine Surgeon at Somers Orthopaedic Surgery & Sports Medicine Group. 

After completing advanced spine surgery fellowship training at the Texas Back Institute, Dr. Perfetti developed a special focus on motion-preserving spine procedures, including cervical and lumbar Total Disc Replacement. He is one of the few spine surgeons in the New York and Connecticut region performing both cervical and lumbar disc replacement procedures.

Dr. Perfetti specializes in treating chronic neck pain, chronic back pain, degenerative disc disease, herniated discs, spinal stenosis, and other spine conditions using both surgical and non-surgical treatment approaches.

Frequently Asked Questions About Total Disc Replacement

What is the difference between spinal fusion and Total Disc Replacement?

Spinal fusion permanently joins two bones together to stop movement at a painful part of the spine. Total Disc Replacement removes the damaged disc and replaces it with an artificial disc designed to help preserve movement. The right procedure depends on the patient’s condition, spinal stability, and overall health.

Can Total Disc Replacement help treat chronic lower back pain?

Some patients with chronic lower back pain caused by damaged spinal discs may qualify for lumbar Total Disc Replacement. Eligibility depends on imaging findings, spinal stability, symptoms, and overall health.

What is an annular tear?

An annular tear is a tear in the outer layer of a spinal disc. In some patients, annular tears may contribute to chronic neck pain or lower back pain.

Who may qualify for cervical or lumbar disc replacement?

Adults between ages 18 and 60 with chronic disc-related neck or back pain that has not improved with conservative treatment may qualify for evaluation depending on their condition and imaging findings.

Is Total Disc Replacement FDA approved?

The Centinel Spine prodisc® platform includes FDA-approved systems for cervical and lumbar disc replacement.

Considering Treatment Options for Chronic Neck or Back Pain in New York or Connecticut?

Chronic neck or back pain can affect movement, activity, work, and daily routines. For some patients, Total Disc Replacement may be one option to consider when exploring alternatives to spinal fusion surgery.

Dr. Dean Perfetti evaluates patients throughout Somers Orthopaedic Surgery & Sports Medicine Group locations in Mount Kisco, Carmel, Newburgh, Fishkill, and Danbury to determine whether artificial disc replacement or another spine treatment approach may be appropriate.

To learn more, contact Somers Orthopaedics at 845-278-8400 or select a location to request an appointment.

This content is intended for educational purposes only and should not replace professional medical advice, diagnosis, or treatment. Individual results vary, and not all patients are candidates for Total Disc Replacement surgery.

Author

Somers Orthopaedic Surgery & Sports Medicine Group