A big question many spinal patients ask is: Can spinal discs be replaced? In other words, is there any alternative to inserting screws? And the answer is: Yes.

What is a vertebral disc? A vertebral disc is a cushion, a shock absorber between the vertebrae. Occasionally, it ruptures, allowing the nucleus, a kind of jelly-like substance, to escape; this is called a herniated disc. In other cases, the disc has become dehydrated or worn down by the movement of the vertebrae and no longer performs its function. Is it possible to replace this disc? Yes.

There are cervical discs and lumbar discs. They are broadly the same, with some differences. Cervical discs, for example, are smaller, and although patients have great respect for this area, disc replacements are usually of excellent quality and last a lifetime, making them the best option for cervical surgery when surgery is necessary, whether for disk osteoarthritis, herniated discs, or spinal cord compression.

A nivel lumbar también se pueden cambiar los discos, incluso son los que marcan las notorias diferencias entre una buena y una mala cirugía. Si el paciente reúne las condiciones adecuadas y sus lesiones se encuentran en L5-S1 y L4-L5, es posible colocar prótesis discales a nivel lumbar por la parte de abajo, que funcionaran como discos vertebrales.

There are times when it is not worthwhile to place disc prostheses below L5-S1 and the option is to place a disc called an "ALIF cage" that acts as a vertebral disc, providing height to the nerves, allowing them to breathe, oxygenate and consequently, the pain to decrease or disappear.

At Biziondo, we frequently discuss the use or non-use of screws. These were a great invention in the 1980s and are still useful today. However, the big difference between successful placement and failure lies in the use of discs. For example, if screws must be inserted because the displacement is too large, there is severe scoliosis, or there is simply no other way to correct a patient's problem, placing screws with a disc in the middle acting as support will make these screws very solid. If screws are inserted without discs, without any support in front, this will cause problems for the patient.

40% of surgeries involving screw placement without discs or anterior fixation end up being problematic. Over time, the discs can become loose, causing micro-movements in the vertebrae, and in turn, the patient's pain will not decrease.

In countries like France, this technique has been used for 20-30 years. Fortunately, this technique is becoming increasingly popular in Spain, with the French Biziondo Spine Institute being one of the centers where this type of procedure is performed.

In the future, it's possible that more and more traumatologists and neurosurgeons will implement these techniques, and most spinal patients will have disc replacements to help resolve their spinal problems.