Separately or together, age and trauma conspire to deteriorate the rubbery cushions known as the vertebral discs that lie between your vertebrae. Flattened, ruptured, or herniated discs are one of the top causes of low back pain and are at the root of 90% of all cases of sciatica.
Jocelyn R. Idema, DO, our spine expert and highly trained orthopedic surgeon at Steel City Spine and Orthopedic Center, may recommend artificial disc replacement when more conservative measures fail to control your pain.
Disc replacement is preferable to spinal fusion — a procedure that welds your vertebrae together — because it preserves spinal motion.
Why your disc herniated
The discs that separate your vertebral bones from one another act as shock absorbers and cushiony protectors, so you can move your spine freely and painlessly in multiple directions. They also absorb the brunt of force when you walk, run, or jump.
Healthy discs have a jelly-like center enclosed in a tough outer shell. You might think of them as something like jelly doughnuts, except with more jelly and tougher dough.
As you age and subject your spine to wear-and-tear, the outer cover develops weak or damaged spots. When the outer cover weakens, the inner gel may bulge out until the cover ruptures.
You then have a herniated disc that lets the gel seep out of the disc and press against adjacent nerves, causing inflammation, swelling, and pain.
A damaged, flattened disc can’t do its job anymore, either. The vertebrae it’s supposed to separate then start to grate against one another. Pain that might have seemed mild when the disc first started to bulge can gradually or suddenly turn into excruciating pain.
Make lifestyle changes first
When you’re in pain, you might look for an instant solution, or jump to a surgical treatment that’s not appropriate for your case. That’s why working with an expert like Dr. Idema is so important. She evaluates your spine and the ruptured disc to determine the extent of damage.
In most cases, she advises that you start healing your disc by limiting your activities for several days. She then may recommend engaging in closely supervised physical therapy to build up strength and flexibility in the supporting muscles, tendons, and ligaments in your spine.
If your pain doesn’t improve, she may gradually add more potent, supportive therapies as needed. For example, you may need an epidural steroid injection for extended pain relief. The epidural allows you to complete physical therapy without pain.
Luckily, about 90% of all patients who undergo nonsurgical treatment have reduced pain within three months. As long as you continue to improve, Dr. Idema recommends sticking with conservative treatments for up to six months.
If your pain isn’t better at the six-month mark or if you never improved with conservative therapies, she may recommend surgery. She offers various types of minimally invasive surgery including disc replacement surgery.
Candidates for disc replacement
Not everyone benefits from disc replacement to reduce their back pain and improve mobility. Disc replacement is more successful when:
- Just one or two lumbar discs cause your pain
- You don’t have facet joint disease
- You’re not overweight
- You haven’t had a previous spine surgery
- You don’t have a spinal deformity such as scoliosis
Dr. Idema only recommends the type of surgery that’s best for your spine and overall health.
Benefits of disc replacement
The gold standards of treatment for herniated discs were once discectomy (surgery to remove the disc), followed by spinal fusion.
During spinal fusion, we place bone graft material into a spacer and then insert it in place of the disc. Over the next several months, new bone grows, fusing the vertebrae together and creating one strong bone.
Disc fusion effectively relieves pain and stabilizes your spine. The main drawback is that fusion also prevents movement between the fused vertebrae.
Dr. Idema is an expert in a minimally invasive surgery that removes the herniated, flat disc and replaces it with an artificial disc made of biocompatible materials. The artificial disc preserves spinal movement, restores spinal stability, and places less stress on the adjacent discs when compared to a traditional bone fusion.
If you have back pain, contact us today by phone or online request form to find out if you’re a candidate for artificial disc replacement. We have offices in Pittsburgh, McKees Rocks, and Washington, Pennsylvania.