Dr. Taghva believes in motion sparing and minimally invasive alternatives to fusion for the appropriate patients. He is a regional expert in spinal disc replacement.
Who Is Dr. Alexander Taghva?
Dr. Alexander Taghva is a board-certified neurosurgeon in Orange County, California. He practices a variety of non-invasive treatments in addition to surgery. Regardless if a patient has Parkinson’s disease or a brain tumor, Dr. Taghva is skilled at minimally-invasive surgery.
After graduating Summa Cum Laude from the University of Southern California, Alexander Taghva earned his degree from Johns Hopkins University School of Medicine. Since then he has learned an array of techniques to find the least invasive solution possible. As a member of the Congress of Neurological Surgeons, he has continued to educate himself on current research.
Dr. Taghva is a regional expert for cervical and lumbar artificial disc replacement and sees many patients who were offered only fusion alternatives, such as anterior lumbar interbody fusion or posterior lumbar fusion, by other surgeons. In many cases, Dr. Taghva is able to offer non-fusion, disc replacement alternatives for these patients with one- and two-level disc disease in the low back.
Dr. Taghva is one of the few surgeons nationally with direct surgical experience with multiple artificial discs approved for one- and two-level use in the United States. For example, Dr. Taghva was the first surgeon in Orange County, California to implant the NuVasive Simplify disc.
As a result, Dr. Taghva is able to select the correct disc for a patient’s anatomy and has a nearly 100% success rate with disc replacement over hundreds of cases, with no patients requiring explantation or conversion to fusion. Dr. Taghva is a firm believer in the technology and sees his patients having preserved range of motion, less pain, and less adjacent segment disease than similar patients with fusion. Due to his expertise, Dr. Taghva performs disc replacement on an outpatient basis, with nearly all patients going home within 24 hours of surgery.
Most patients wear a lumbar brace for two-weeks following disc replacement and are able to go back to pre-surgical activities by six weeks after surgery. Dr. Taghva received his medical degree at Johns Hopkins University School of Medicine, his residency at the University of Southern California with fellowship training at The Ohio State University. He is a board-certified neurosurgeon and has been voted by his peers as a Orange County Physician of Excellence consecutively for the past six years as well as being voted a Super Doctors Rising Star.
Degenerative disc disorders of the spine are among the most frequent causes of low back pain and may require surgical treatment such as lumbar disc replacement. In Mission Viejo, CA, board-certified neurosurgeon Dr. Alexander Taghva specializes in minimally invasive techniques and has extensive experience performing intricate lumbar spine surgery and lumbar disc replacement.
How Is Lumbar Artificial Disc Replacement Performed?
Lumbar disc replacement is performed through an anterior approach incision below the belly button. It takes roughly 1 hour per level and is performed on an outpatient basis. The surgical team consists of a neurosurgeon who operates on the spine as well as a vascular surgeon who makes the abdominal incision and protects important blood vessels in front of the spine.
The surgical approach is similar to that of an anterior lumbar interbody fusion (ALIF), but the implanted prosthetic allows for motion between the two vertebrae. In a spinal fusion, an implanted prosthetic is designed to stop motion between the two vertebral segments. Following surgery, patients are required to wear a lumbar brace for two weeks. Patients are, however, able to do light activity such as walking at that time. Most patients resume their normal activities between 6 weeks and 3 months following surgery.
Who Qualifies for Lumbar Artificial Disc Replacement?
While lumbar artificial disc replacement is an excellent alternative to fusion, there are strict criteria to determine who is a candidate for the procedure. Good candidates have imaging evidence of one or two-level disc disease (most commonly at L4-5 and L5-S1), are in good health with solid bone quality (not osteoporosis), have a normal BMI, and have failed at least 6 months of conservative management. A lumbar artificial disc replacement works best with individuals who already live a healthy lifestyle.
Certain key exclusion criteria are used to determine if a patient is unlikely to have a good outcome from artificial disc replacement. Smoking is only one of the factors.
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Conditions that can prevent Lumbar Artificial Disc Replacement
Those who have had a previous lumbar spine surgery (except microdiscectomy orange county or unilateral laminotomy) may not qualify for treatment. This is also true if an individual has
spinal stenosis, severe facet degeneration, scoliosis, unstable spondylolisthesis, or osteoporosis.
A history of rheumatoid arthritis or other autoimmune disorders can be problematic. Obesity may also decrease the odds of a successful outcome. In some patients a disc replacement must be converted to a fusion due to intraoperative findings.
With good candidate selection, patients with artificial disc placement have significant improvements in pain, medication use, and quality of life measures. These improvements persist with long term follow-ups.
Currently two artificial disc options are available in the US: the ProDisc L and ActivL. For more information, Dr. Taghva provides an initial consultation for all patients.
Frequently Asked Questions about Lumbar Artificial Disc Replacement
It depends on the individual. Before performing any type of treatment a patient will be examined to determine the cause and type of care they will receive. Non-invasive surgery is extremely effective when used correctly.
No. Not only are they not mandatory, but they may not be necessary. Pain can be treated with non-invasive options for those suffering. While most people choose to use pain medication after surgery, it is not required for any patient.
Nerve pain can be caused by several different conditions. A damaged disc or bone spurs can both cause painful sensations in the spine. Non-surgical techniques such as spinal cord stimulation and foraminotomy may relieve this specific pain depending on the individual.
Lumbar disc replacement is typically performed on an outpatient basis, so patients are able to return home within 23 hours of surgery. After care nursing options are available to assist with any needs in days following surgery. Patients generally wear a lumbar brace for the first two weeks after surgery when they are out of bed. Outpatient physical therapy is started about 6 weeks after surgery.
Booking an Appointment
Insurance carrier approval is a major barrier to lumbar artificial disc replacement. If your insurance does not approve your surgery, alternative financing options are available. Factors influencing of the cost of lumbar disc replacement include implant cost, number of levels treated, anesthesia cost, vascular and neurosurgeon costs, operating room costs, nursing and after care. Out of pocket costs for lumbar disc replacements not covered by insurance vary widely, but are generally upwards of $70,000 per level at many centers. Through partnership with the Medicare-accredited GALEA Center for Advanced Surgery, Dr. Taghva is able to provide significant discounts to patients by bundling these components to provide fair “all-in” pricing. To learn more about non-invasive treatments for neck and lower back pain, call 949-403-6912 or schedule an appointment with Alexander Taghva in Orange County, California.
