Can Bone Spurs on the Spine Be Fixed With ADR?

Yes, bone spurs on the spine can be treated with artificial disc replacement (ADR), especially when they result from degenerative disc disease. During this advanced disc replacement surgery, the damaged disc and excess bone growth are removed to relieve pressure on the spinal nerves and ensure long-term spinal stability.

At Total Orthopedics and Sports Medicine, our surgeon uses motion-preserving techniques and a precise surgical approach to remove damaged disc material and decompress surrounding nerves. To make your treatment process smooth, we also offer a secure patient portal, online payment options, coordinated referrals, quick access to medical records, and pre- and post-surgical guidance. Call us at 855-321-6784 to get targeted surgical care focused on preserving motion.

How Are Bone Spurs Removed During ADR Surgery?

During artificial disc replacement (ADR), surgeons make a small incision and gently retract soft tissues to access the spine. They then use precision tools such as high-speed drills, burs, and specialized chisels to remove bone spurs and prepare the area. Once the site is cleared, the damaged disc is carefully removed. After removing the degenerated disc, the surgeon uses specialized instruments, such as burrs or curettes, to shave excess bone growth.

They often use fluoroscopy (real-time X-ray) for guidance and intraoperative CT or navigation tools to fully decompress the nerve roots, creating a clean space for the artificial disc, which helps restore normal motion. In fact, a Science Direct study on anterior lumbar total disc replacement found that image-guided navigation improves localization within the disc space and assists with lateral recess and foraminal decompression.

What Types of Bone Spurs Respond Best to ADR?

Bone spurs caused by a herniated disc that compress nerves or the spinal cord respond best to artificial disc replacement. Soft, disc-level osteophytes located around the affected artificial disc space are also ideal, as they can be removed while restoring motion and relieving pain.

Additionally, several other types of bone spurs respond best to ADR, such as:

• Anterior and Lateral Osteophytes: Bone spurs located on the front or sides of the vertebral body, often associated with disc height loss, respond well to ADR, which restores stability.
• Marginal Osteophytes: These are small, initial bony growths that develop along the edges of the vertebrae during early to moderate osteoarthritis.
• Foraminal Disc-Osteophyte Complex: While severe cases may require complex surgery, surgeons can treat mild-to-moderate bony growths in the foramen with a replacement procedure that reduces pressure and stress on the affected nerves.

In contrast, progressive ossification can reduce motion over time, especially when bone growth extends beyond the disc space or becomes heavily calcified. This is why patients with multi-level disease, large osteophytes, or ligament ossification may not achieve optimal outcomes with ADR and may require alternative surgical procedures.

What Factors Affect the Bone Spurs Removal With ADR?

Bone spur removal during artificial disc replacement (ADR) depends on spur size, location, severity of nerve compression, disc degeneration level, and surgical access. Surgeon expertise, bone quality, and anatomical accessibility also play important roles in effectively removing bone spurs while preserving surrounding structures. Here’s how these factors affect bone spur removal with ADR:

1. Location and Size of Osteophytes

The location of bone spurs dictates their proximity to nerves and soft tissues. On the other hand, size correlates with the degree of functional limitation and technical challenges during removal. If spurs are extremely large or deeply embedded, it makes ADR difficult or impossible, sometimes requiring spinal fusion surgery.

2. Surgical Approach and Tools

Surgeons remove bone spurs using precision instruments through a small incision, typically via an anterior approach. This method provides direct access to the disc and front-facing osteophytes, allowing accurate decompression. However, removing posterior bone spurs is more challenging because straight-line instruments cannot reach around the spinal canal.

3. Implant Type and Design

Fixed-core implants provide stability but require precise bone preparation. On the other hand, mobile-core designs better accommodate motion and proper alignment. Similarly, viscoelastic discs mimic natural shock absorption and may reduce stress on endplates. Additionally, certain implants feature keels, spikes, or porous coatings to secure fixation and reduce the potential risk of new bone spur formation.

4. Surgical Skill/Experience

The surgeon’s ability to thoroughly remove posterior osteophytes is an important factor in preventing postoperative symptoms. The reason is that failure to remove them can lead to continued spinal cord compression and may require revision surgery.

5. Single or Two-Level Disease

Patients with single or two-level spinal disease are suitable candidates for ADR because the procedure is designed for motion preservation at the degenerative disc. At these levels, lumbar spine surgeons can achieve complete removal and effective decompression without compromising spinal stability.

How Does Pre-Existing Bone Quality Affect Bone Spur Removal?

Pre-existing bone quality, such as weak or osteoporotic bone, increases surgical complexity, limits complete spur excision, and increases the risk of complications during spine surgery. In contrast, dense, healthy bone allows precise removal and stable implant placement while restoring function.

Additionally, poor bone quality can affect implant fixation and long-term outcomes. Since artificial discs depend on strong vertebral endplates for stability, weakened bone may increase the risk of implant subsidence or migration. However, a PMC systematic review reported that clinicians may still select patients with BMD 1.5 SD below the mean for total disc arthroplasty. To ensure appropriate patient selection and reduce complications, ADR surgeons may perform DEXA scans to evaluate bone health status and guide surgical planning.

How Do Surgeons Protect Nerves While Removing Bone Spurs?

Dr. Georgiy Brusovanik, our spine surgeon with national media exposure for minimally invasive techniques, uses high-resolution imaging, surgical microscopes, and endoscopic guidance to protect nerves during bone spur removal. He uses minimally invasive techniques and high-speed drills with specialized burs or micro-forceps to remove bone safely while reducing the risk of nerve injury and maintaining motion.

To improve safety, Dr. Georgiy Brusovanik also uses intraoperative neuromonitoring (IONM), which continuously tracks nerve signals and alerts to potential irritation or pressure. Additionally, he may employ gentle tissue retraction and controlled bone shaving techniques to minimize spinal trauma. In complex cases, he may remove spurs in small stages to maintain clear visibility and avoid direct nerve contact. For expert spine care, reach out today to schedule an appointment with our doctor.

Why Are Some Spurs Not Fully Removed During ADR?

Surgeons may not fully remove some bone spurs during ADR due to their location, size, or proximity to delicate neural structures. In complex cases, surgeons prioritize nerve protection and spinal stability, while leaving small or hard-to-reach osteophytes that do not compress nerves or ADR spine.

During ADR, their primary goal is neural decompression and to reduce discogenic pain rather than bone removal. Therefore, they may leave deeply embedded posterior spurs or those fused with endplates to avoid weakening vertebral support. The reason is that complete excision could increase the risk of fracture, instability, or endplate damage affecting implant longevity. An NCBI study also reports that endplate integrity is essential for implant support, and excessive bone removal can weaken these structures, increasing the risk of fracture or implant subsidence.

Can Partial Spur Removal Relieve Nerve Pressure?

Yes, partial bone spur removal can effectively reduce pressure when complete excision is not safely possible. By decompressing the affected nerve root and creating more space within the spinal canal, surgeons can reduce chronic back pain while preserving surrounding bone stability and restoring mobility.

In many spine cases, surgeons intentionally remove only the portion of the spur that directly compresses the nerve, especially when the remaining fragment is stable and not causing significant stenosis. To perform partial removal, they perform the following approaches:

• Advanced imaging: Helps precisely identify the location and extent of nerve compression before and during surgery.
• Minimally invasive techniques: Targets the exact compression point while reducing trauma to nearby tissues and structures.

This approach provides significant pain relief with spinal integrity, particularly in areas where complete removal could increase the risk of nerve irritation or structural weakening. A Europe PMC study found that 78 patients with lumbar nerve root compression most often had leg pain and about half showed muscle weakness. Many cases were caused by degeneration in the facet joints. In such cases, surgeons used a partial facetectomy to relieve pressure while keeping the spine stable. As a result, 59% of patients had good outcomes, and 85% were satisfied.

Can Removing Bone Spurs Irritate Nearby Nerves?

Yes, removing bone spurs can temporarily irritate nearby nerves due to surgical manipulation, swelling, or mechanical contact during decompression. However, this irritation is usually short-term and improves as inflammation reduces, and the nerves begin to heal after pressure relief. Moreover, after bone spur removal, previously compressed nerves may become hypersensitive as blood flow and signaling return. This can cause temporary symptoms like tingling, radiating pain, or discomfort.

When to see a doctor: Contact your surgeon if you experience worsening pain, loss of bowel control, or severe symptoms that do not respond to conservative treatments.

Does ADR Fix the Cause of Bone Spur Formation?

No, ADR does not fix the underlying cause of osteophytes, which is usually degenerative disc disease, instability, or chronic, localized spinal stress. While ADR removes existing spurs and restores motion, it aims to treat symptoms rather than reverse the aging or degenerative process that causes bone growth. Additionally, bone spurs that have already formed may remain even after surgery, especially if they are not causing nerve compression. Ongoing adjacent segment degeneration or underlying arthritis can also affect long-term outcomes, making regular follow-up important for monitoring your spinal health.

How Does Spur Removal Affect Spinal Balance?

Spur removal can improve gait and spinal balance by opening the canal and relieving abnormal nerve pain, numbness, and muscle weakness. However, removing extensive bone or altering surrounding structures can cause temporary instability until healing restores proper spinal support and coordination.

Other than this, spinal balance depends on coordinated interactions among replaced discs, facet joints, ligaments, and surrounding muscles. In most cases, reduced inflammation or progressive healing improves alignment and helps maintain long-term balance, especially when proper lifestyle modifications address pre-existing degeneration. Moreover, doctors may suggest posture-correction exercises to further strengthen the core muscles.

What Are the Symptoms of Incomplete Spur Removal?

Persistent pain, ongoing nerve compression, or symptoms such as numbness, tingling, muscle weakness, stiffness, and limited mobility indicate incomplete spur removal. In such cases, patients may experience symptom recurrence shortly after surgery due to residual bone spur fragments or continued nerve irritation.

Beyond these primary signs, many patients may notice that these symptoms:

1. Recovery slows or stops instead of steadily improving. This may occur when a small portion of the bone spur remains and continues to irritate nearby nerves or limit spinal movement.
2. Persistent stiffness and reduced joint mobility (e.g., shoulder, knee, or hip). It can indicate that structural impingement has not been fully resolved.
3. Ongoing inflammation around the surgical site. This may mimic pre-surgery symptoms, making it difficult to distinguish between normal healing and incomplete decompression.

Therefore, doctors conduct follow-up imaging, such as X-rays, to assess for residual osteophytes. If symptoms persist or worsen over time, a surgeon may consider a revision procedure to decompress the affected nerve.

How Does ADR Compare to Fusion for Bone Spurs?

ADR generally preserves spinal motion and reduces stress that can contribute to future bone spur formation. On the other hand, spinal fusion eliminates movement at the treated level but may increase stress on adjacent segments. Over time, this stress may speed up wear and lead to the formation of new bone spurs.

Besides this, artificial disc replacement maintains natural motion at the operated level, helping evenly distribute load across the spine. This can reduce the risk of adjacent segment disease over time. According to an NCBI review, fusion is associated with adjacent-segment degeneration. In contrast, total disc replacement helps avoid these complications by preserving motion at the operated level. Another PubMed analysis reported that ADR provides better functional outcomes. It also reduces biomechanical overload on adjacent segments compared to fusion, supporting its role in limiting long-term degenerative changes.

Book a Consultation With Dr. Georgiy Brusovanik to Determine If ADR Is The Right Treatment For Your Bone Spurs!

If you’ve bone spurs in the spine, you may notice persistent back pain, stiffness, or radiating discomfort traveling down your arms or legs. As these bony growths press against nearby nerves, they can trigger numbness, tingling, and muscle weakness, making simple movements difficult.

At Total Orthopedics and Sports Medicine, Dr. Georgiy Brusovanik uses precision-based surgical techniques and biomechanical assessment to identify the exact source of nerve compression and degeneration. Rather than addressing symptoms, he restores spinal alignment, preserves natural motion, and reduces mechanical stress that causes spur formation. Visit us at 1111 Park Ave, #1, New York, 10128, and contact 855-321-6784 to book your consultation.

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