Best Hospitals for Disc Replacement Surgery in Bengaluru, India

Intervertebral disc disease — encompassing degenerative disc disease (DDD), disc herniation with radiculopathy, and cervical or lumbar myelopathy — results from the progressive biochemical breakdown of the nucleus pulposus and annulus fibrosus. As proteoglycan content diminishes, the disc loses hydrostatic pressure, collapses, and can no longer function as a shock absorber. The resulting foraminal stenosis or central canal compromise impinges on nerve roots or the spinal cord, producing pain, paraesthesia, muscle weakness, and — in advanced cervical cases — myelopathic gait disturbance. Left untreated or managed only conservatively in refractory cases, single-level or two-level disc disease causes measurable loss of functional capacity, reduced quality of life scores (as measured by the Neck Disability Index [NDI] and Oswestry Disability Index [ODI]), and secondary adjacent-segment stress.

IDEAL Surgical CANDIDATES:

• Single-level or two-level symptomatic cervical disc disease (C3–C7) causing radiculopathy or mild-to-moderate myelopathy, refractory to ≥6 weeks of structured non-operative management (physiotherapy, NSAIDs, epidural steroid injections)
• Single-level lumbar disc disease (L4–L5 or L5–S1) with disc herniation or DDD causing radiculopathy or neurogenic claudication, unresponsive to ≥3–6 months of conservative care
• NDI score ≥30% or ODI score ≥30% confirming functional disability
• MRI-confirmed disc pathology with preserved facet joint anatomy (Fujiwara Grade 0–II; Pfirrmann Grade II–IV disc degeneration)
• Patient age typically 18–60 years (relative upper limit due to bone quality and degenerative facet status)
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Required Pre-operative DIAGNOSTICS:

Surgical Approaches & TECHNIQUES:

1. CERVICAL TOTAL DISC REPLACEMENT (C-TDR) — ANTERIOR CERVICAL APPROACH:

Performed via a standard Smith-Robinson anterior cervical approach under general anaesthesia with neuromonitoring (somatosensory evoked potentials [SSEPs] and motor evoked potentials [MEPs]). Discectomy is completed with a Caspar retractor system, followed by posterior longitudinal ligament (PLL) resection for complete neural decompression. Endplate preparation uses precision milling instruments specific to the implant system. Implant footprint is matched to endplate dimensions using intraoperative fluoroscopy or, increasingly, intraoperative CT (iCT) navigation for accurate midline and depth positioning. FDA/CE-approved systems include: Mobi-C (ball-in-trough, unconstrained, approved for 1 and 2 levels), Prestige LP (titanium ceramic composite, stainless-steel rail-and-trough), Simplify Disc (silicon nitride ceramic core), and ProDisc-C Vivo (semi-constrained, CoCrMo/UHMWPE). Two-level C-TDR carries Level I evidence of superiority over two-level ACDF for NDI improvement and reoperation rates at 84 months.

2. LUMBAR TOTAL DISC REPLACEMENT (L-TDR) — ANTERIOR RETROPERITONEAL APPROACH:

PRE-OPERATIVE PHASE (Weeks 1–2 Before Surgery):

• Week 1: Remote consultation with GAF Healthcare's spine surgeon panel via telemedicine. Upload MRI, CT, DEXA, and X-ray DICOM files for case review. Surgeon provides a formal surgical indication report and implant recommendation.
• Week 2: Travel to India or UAE. On-arrival full pre-operative workup: blood panel, ECG, anaesthesia assessment, and repeat standing X-rays. Physiotherapy baseline functional assessment (NDI/ODI scoring). Informed consent with implant selection finalised. Cease NSAIDs and anticoagulants per surgeon protocol (typically 7 days prior).

DAY OF SURGERY (Day 0):