Wednesday, January 23, 2013

Spinal Fusion and Artificial Disc replacement surgery for Degenerative Disc Disease


Spinal Fusion and Artificial Disc replacement surgery

Degenerative disc disease is one of the most common causes of low back pain. Not only Degenerative disc disease is the most common cause, it is misunderstood name for the disease and people suffering from it often bewilder rather are scared about “Degeneration” of their back and how worse their life would become in few years.  The most common fear in people diagnosed with degenerative disc disease is if this would cripple their life and they would end up in a wheelchair.
It’s not all in the name
The word “degenerative disc disease” is a misnomer and is interpreted by most as progressive, threatening condition.  Spinal experts say that the condition is not strictly degenerative and is not really a disease.  The confusion is because of the name- “degenerative”, which actually implies to the disc degeneration and not the symptoms. The disc may degenerate with time, which is the natural aging process, but the pain or symptoms may not.  Experts even claim that pain can even improve with time and this is not a disease at all. Degenerative disc disease is a condition resulting from the damaged disc.
Degeneration of disc is a natural aging process and all people exhibit changes in their spine- some may exhibit more change than others and those showing more experience pain.

Symptoms of Degenerative Disc Disease

A person with degenerative disc disease is usually an otherwise healthy person in thirties or forties  with no continuous or severe pain.  Degenerative disc disease pain is usually more related to activity and will flare up at times but then return to a low grade pain level or the pain will go away entirely.
The typical symptoms are as follows:
·  The pain gets worse with sitting, since in the seated position the lumbosacral discs are
    loaded three times more than standing.

·  Few activities may worsen the pain which includes bending, lifting and twisting.

·  Walking and running may actually feel better than prolonged sitting or standing. Changing
    position frequently feels helpful.

·  Lying down usually feels the best, because it relieves stress on the disc space.

Treatment of Degenerative Disc Disease

When conservative treatments such as pain killers, rehabilitation, physical therapy and injections fail to improve the symptoms, surgery is recommended to help patients lead a normal, pain free life. 

Spinal Fusion

Spinal Fusion is the best surgical process to treat the painful degenerative disc. Spinal fusion surgery stops the motion at a painful vertebral segment which reduces the pain generated from the joint. The surgery works by adding a bone graft in the area of spine which is painful. The bone graft sets up a biological response which makes the bone graft to grow between the vertebral elements thereby creating a fusion and stopping the movement.
There are many approaches to performing a spinal fusion surgery, but the basic idea remains the same.  The bone graft is either taken from the patient’s hip or from a cadaver or is a synthetic bone graft, causes two vertebral bodies to grow together into one long bone.
It is observed that lumbar spinal fusion surgery is most effective in conditions involving one segment of the spine.  Fusion at two levels may be a reasonable option in relieving the pain. But spinal fusion surgery for more than two levels removes too much of normal motion placing too much stress across the remaining vertebral joints. It is advisable only in rare cases like scoliosis and lumbar deformity.
There are various techniques of performing the lumbar fusion surgery. Few of which are:

·     Anterior lumbar interbody fusion (ALIF) - the procedure is done from the front and includes removing the disc between two vertebrae and inserting bone into the space created between the two vertebral bodies

·     Anterior/posterior spinal fusion - the procedure is done from the front and the back.

·     Posterolateral gutter fusion - the procedure is done through the back

·     Posterior lumbar interbody fusion (PLIF/TLIF) - the procedure is done from the back and includes removing the disc between two vertebrae and inserting bone into the space created between the two vertebral bodies

Artificial disc replacement

Though spinal fusion helps to relieve pain, it has disadvantages such as loss of motion and flexibility in the area treated and can lead to degeneration of other discs above and below the discs that are fused.
Artificial disc replacement is an alternative to spinal fusion. It is reversible and avoids shortcomings of spinal fusion. The artificial disc allows motion preservation, distributes the stress along the spine and restores the pre degenerative disc height thereby reducing the damage to nearby discs and joints.
artificial disc replacement
Artificial disc replacement
Artificial disc replacement surgery is similar to hip or knee joint replacement, the artificial disc substitutes mechanical device for intervertebral disc in the spine. The device is meant to restore motion to the spine by replacing the worn, degenerated disk.
Another advantage of artificial disc replacement is low down time. Patients return to normal activities is rapid after disc replacement than spinal fusion. It is because fusion patients can perform limited activities during the time required for the graft to grow into a solid mass. Because it aims at preserving the motion, patients are encouraged to return to motion relatively fast but in gradual progression.
The only down side of artificial disc replacement surgery is that since it is new, the long term results are not known. Spinal fusion has a long standing record of success in permanently correcting problems in the fused segment.           
If you are suffering from degenerative disc disease and need a surgery or have been advised to undergo lumbar spinal fusion surgery or artificial disc replacement surgery and do not afford it in your country or the facilities are not much advanced, visit  write to us info@indicure.com or call us at +91 9818462127 or +91 9320036777.