Most people experience neck or back pain at some point in their lives. For some, the discomfort is temporary. But for others, the pain persists, making everyday activities difficult.
Neck and back pain can have many causes. One is the wearing down of spinal discs known as degenerative disc disease. At Summit Health, our orthopedists always focus on conservative, non-operative treatments first such as physical therapy and steroid injections before considering surgery. If these methods are not successful, surgical solutions can be helpful for many people.
Neel P. Shah, MD, an orthopedic surgeon at Summit Health specializing in minimally invasive and microscopic spine surgery, discusses a relatively new treatment called disc replacement surgery and its potential advantages in treating chronic neck and back pain.
1. Disc degeneration is a normal part of aging.
Spinal discs are the rubbery cushions between the spinal bones called vertebrae. Your discs act as shock absorbers in the neck (cervical) and lower back (lumbar) spine and help with movement and flexibility.
Discs wear down with age. Most people have some disc degeneration after age 40, although not everyone has symptoms. But for some, weakened discs can cause problems. “When discs go bad, the bulging disc, reaction from the vertebrae (bone spurs), and loss of space for the nervous system components can cause pinching of the spinal nerves or the spinal cord,” says Dr. Shah.
In addition to neck pain and back pain, degenerative disc disease symptoms can include:
- Numbness or tingling in the arms or legs
- Pain that radiates to the arms and hands or the buttocks and legs
- Muscle weakness
- Balance or coordination issues
Neck and back pain treatment usually begins with nonsurgical approaches, such as physical therapy, medications, and steroid injections. But if symptoms fail to respond to these treatments, surgery may be an option.
2. Disc replacement is a relatively new surgical alternative.
Disc replacement surgery involves removing and replacing a damaged disc with an artificial one made of medical-grade metal or plastic. Surgery can replace a cervical or lumbar disc, although Dr. Shah says cervical disc replacements are more common.
The procedure is an alternative to traditional spinal fusion surgery for some patients. Spinal fusion connects two or more vertebrae, so they heal as one bone. While spinal fusion relieves symptoms and may still be the best option for some patients, the fused area is immobilized, affecting normal movement.
Dr. Shah notes artificial disc replacement is gaining favor for its ability to preserve spinal motion. In addition, research shows the procedure creates less stress on adjacent discs than spinal fusion, reducing the likelihood of additional surgeries.
“The beauty of disc replacements is instead of making room for the neural elements with a spacer that doesn’t move, we can put in a device that retains motion and decreases adjacent level stresses,” says Dr. Shah.
Patients with pain caused by one or two discs may be good candidates for disc replacement surgery. Your surgeon will consider other factors, such as imaging tests, health status, and surgical history, to determine the most appropriate treatment.
3. Artificial disc replacement is a minimally invasive option.
While disc replacement surgery is performed differently depending on the damaged disc’s location, both procedures involve a minimally invasive approach.
For cervical disc replacement, the surgeon makes a small incision in the front of the neck to expose the spine. Through this opening, the damaged disc is carefully removed and replaced with an artificial disc selected for an optimal fit. For lumbar replacement, the surgeon approaches the lower back through an abdominal incision.
Surgical times range from 90 minutes to three hours, and patients may spend a night or two in the hospital. In certain cases, disc replacement can be performed as an outpatient procedure. Either way, the less-invasive approach allows for faster recovery and return to normal activities.
“With fusion, you’re looking at three to nine months for recovery versus six to 12 weeks with disc replacement,” says Dr. Shah.
4. When considering disc replacement surgery, look for experience.
Because there are multiple treatment options for disc conditions, it’s important to consult with a trusted provider who can discuss solutions appropriate for your symptoms, needs, and preferences.
“If you’re considering disc replacement surgery, look for and consult with a surgeon who’s experienced in the procedure,” says Dr. Shah. “While spinal fusion and disc replacement surgeries have similar approaches, disc replacement is more technically challenging because the preparation of the disc and precise positioning of the implant affect the outcome of the procedure.”