Disc Replacement Surgery
Introduction
The intervertebral discs play an integral part of the spine. These shock absorbers that are made up of a tough, fibrous outer core and a soft, gel-like centre found between each of the vertebrae not only act as shock absorbers, but aid with flexibility. These discs, along with the facet joints found at the back of the spine, help the body to be able to bend in any direction. Unfortunately, these discs can degenerate over time. The vast majority of people will find relief through more conservative treatments, like rest or pain medication, or less invasive techniques such as epidurals or nerve blocks. A small percentage of patients will need to have the disc removed in order to be relieved from debilitating pain.
Spinal Fusion – The Traditional Treatment
The traditional treatment for those patients with a severely degenerated disc is to remove the disc and fuse the surrounding vertebrae together. Once the disc is removed, the space is packed with bone grafts, which over time creates a solid, bony bridge between the vertebrae. While this treatment is successful in alleviating the pain associated with the degenerated disc, there are downsides to this procedure. Because the area is no longer flexible due to the bone graft, the patient will lose some range of motion. Also, this treatment tends to put additional pressure on discs located at a higher level of the spine, ultimately leading to degeneration.
Disc Replacement – The Latest Technology
Replacing the disc with an artificial disc is the most modern treatment available. While it has been available in continental Europe since the early 1990’s, few medical centres in the UK offer this surgery, although it is growing in practice and popularity. While this procedure doesn’t decrease the amount of recovery time needed, the patient will experience a better range of motion and long term health of the spine as opposed to spinal fusion.
While disc replacement can significantly decrease the amount of debilitating pain, this procedure is not for everyone. Candidates for this surgery are those that have experienced high levels of pain for over six months and have explored other avenues of treatment before undergoing this major surgery. Conservative treatments include pain killers, physiotherapy, lumbar epidurals or nerve blocks.
The Procedure
Disc replacement surgery must be performed under general anaesthetic. The spine is approached through the abdomen and the degenerated disc is removed. An artificial disc is then inserted between the two vertebrae. Patients usually will stay in the hospital a few days after the procedure and should be able to stand with assistance within forty-eight hours. Patients should be able to move around on their own before they are discharged. A physical therapist will give patients specific exercises to perform while they are recovering. After six weeks, the patient will have a full check up and a more structured therapy may be suggested.
