Motion Preservation · Lumbar Spine
Lumbar Disc Replacement
Orthopedic Spine Surgeon — Long Beach & Torrance, CA
A motion-preserving surgical procedure that removes a damaged lumbar disc and replaces it with an artificial prosthesis — eliminating discogenic pain, restoring disc height, and maintaining the lumbar spine's natural flexibility.
- > 90%
- report significant pain reduction
- 1–2
- nights average hospital stay
- 6–12 wks
- average return to full activity
Overview
What is lumbar disc replacement?
Lumbar disc replacement (LDR) treats degenerative disc disease in the lower back by removing the diseased disc through an anterior (abdominal) approach and replacing it with a precisely sized prosthetic device. When a lumbar disc collapses, the resulting loss of disc height and abnormal segmental motion can compress nerves and produce chronic low back pain and leg pain (sciatica). LDR addresses this directly at the source.
Unlike lumbar fusion, LDR maintains segmental mobility — the lumbar spine continues to bend, extend, and rotate through the treated level rather than transferring all motion to adjacent segments. This distinction has meaningful long-term implications for adjacent disc health and functional quality of life.
Who is a candidate?
Patients with one- or two-level lumbar DDD with predominantly axial low back pain who have failed at least 6 weeks of conservative treatment.
Levels treated
Most commonly L4–L5 and L5–S1 — the segments that bear the greatest mechanical load in the lumbar spine.
The approach
Performed through a retroperitoneal anterior approach with a vascular access surgeon, allowing direct disc access without disturbing posterior muscles or neural structures.
FDA-approved
The ProDisc-L devices carry FDA approval with robust IDE trial data demonstrating non-inferiority and superiority to fusion in select populations.
Benefits
Why choose motion preservation?
For appropriately selected patients, LDR delivers equivalent or superior pain relief compared to fusion while protecting the long-term integrity of the lumbar spine. The benefits are most pronounced for active patients with isolated disc disease at one or two levels.
Maintained lumbar mobility
Patients retain bending and rotation at the treated level, supporting more natural movement in daily activity, exercise, and sport.
Adjacent disc protection
Fusion concentrates stress at the levels above and below. LDR distributes load more physiologically, reducing adjacent disc degeneration over time.
No posterior instrumentation
LDR avoids the pedicle screws and rods of posterior fusion, reducing hardware complications and preserving future surgical options if ever needed.
Equivalent or superior outcomes
FDA IDE trial data at 5–7 years shows LDR provides equivalent or superior results in pain, function, and satisfaction compared to ALIF fusion.
Lower reoperation rates
By avoiding fusion complications like pseudarthrosis and adjacent segment disease, LDR patients have lower reoperation rates at 5–10 years.
Improved quality of life
Patients consistently report higher satisfaction with physical function and ability to return to recreational and occupational activities compared to lumbar fusion cohorts.
LDR vs Fusion
Lumbar disc replacement vs ALIF
LDR and anterior lumbar interbody fusion (ALIF) both approach the spine from the front and address the diseased disc. The difference lies in what follows — motion or stillness — and what that means for the rest of your spine over time.
Dr. Ortega’s preference for eligible patients
Lumbar Disc Replacement (LDR)
- Preserves motion at L4–L5 or L5–S1
- No bone graft → no pseudarthrosis risk
- Lower adjacent segment disease burden
- No posterior hardware required
- Lower long-term reoperation rates
- Requires intact posterior elements (facets)
- Not indicated in spondylolisthesis/deformity
Anterior Lumbar Interbody Fusion (ALIF)
- Addresses spondylolisthesis and instability
- Strong deformity correction capability
- Applicable across a broader range of pathology
- Permanently eliminates motion
- Higher adjacent disc degeneration risk
- Often requires posterior instrumentation
- Longer recovery due to fusion consolidation
Not every patient qualifies for LDR. Patients with significant facet arthritis, spondylolisthesis, prior posterior fusion, or osteoporosis are often better served by fusion. Dr. Ortega’s evaluation includes standing X-rays, MRI, and CT scanning to determine the approach most likely to produce the best long-term outcome for your specific anatomy and pathology.
Recovery
What to expect after lumbar disc replacement
LDR recovery follows a structured progression. Because there is no bone fusion to wait for, milestones are determined by anterior incision healing, soft tissue recovery, and the gradual return to loading the lumbar spine. Most patients are pleased by how quickly their leg pain and back pain begin to resolve.
Hospital admission, 1–2 nights
LDR is performed through a retroperitoneal anterior incision with an access surgeon. A short hospital stay of 1–2 nights is typical while early mobilization begins.
Early mobilization at home
Walking is encouraged from day one. Back and leg pain often begin to improve quickly. Restrictions on bending, lifting, and twisting are in place to protect the implant during early healing.
Expanding activity
Driving typically resumes around 3–4 weeks. Structured physical therapy begins, focused on core activation and lumbar stabilization. Many patients return to desk-based work during this period.
Return to full activity
Most patients achieve unrestricted physical activity — including exercise, recreational sport, and manual work — by 8–12 weeks. Physical therapy continues for strength optimization through this period.
Motion maintained, adjacent spine protected
The prosthetic disc is engineered for decades of use. Long-term follow-up demonstrates maintained implant position, preserved segmental motion, and lower rates of clinically significant adjacent segment disease compared to fusion cohorts.