Disc replacement surgery is one of the options for some patients who are facing the prospect of continued pain from a compressed nerve injury. A vertebrae disc or cushion is a gel like cushion with a fibrous outer shell that allows the bones of the spine to float as movements occur. An injury or aging can either create a cushion that bulges and may compress a nerve in the spine, or the cushion may deteriorate and turn into an oatmeal like consistency that also can compress a nerve. In some cases, the cushion may actually have to be removed. Bulging discs can often respond to physical therapy and the pain may subside to a livable degree. In some cases the surgeon may remove the oatmeal like cushion altogether and leave the space open, but much of this depends on where on the spine the anomaly has developed and how the surgeon views the long term implications for the patient. Often the surgeon may choose to do a fusion of vertebrae bones so that the area without a cushion moves with a bone that has cushion protection.
A physician treating someone who has a degenerative disc condition will always attempt first to treat the pain and the condition with anti-inflammatory medicines, physical therapy and epidural steroid injections. But often those conservative procedures don't bring the kind of relief that the patient needs for a normal lifestyle. In that case, the options facing the patient and his surgeon may be limited to bone fusion or if possible, disc replacement surgery. The fusing of vertebrae bones has long been the standard operating procedure (no pun intended) for surgeons following the removal of a damaged cushion. If the surgeon recommends fusion, a bone will be grafted to the empty space on either side of the vertebrae and the bones will eventually grow together. The goal is to stop any abnormal movement that the empty space might be subject to without the disc in place. The bone will either come from the patient or from a graft from a bone bank.
The problem with fusion is the issue of range of motion that may be quite limited by the fusion operation. This may be particularly true if the disc is in the cervical area of the spine. That is the area near the shoulder and neck area. There are a number of risks that are associated with fusion surgery such as the two segments not fusing together. Additionally, there is the possibility that the vertebrae nearest the fusion location will develop problems, usually years later. The surgeon performing the disc replacement surgery will no doubt talk about the possibility of blood loss and infection with the fusion surgery as well as the risk of damage to the spinal cord in rare cases. Because of all these risks there has been an intense push by major medical prosthetic companies to develop artificial discs to replace those that have failed in one way or another and these artificial substitutes for the real thing have made disc replacement surgery a viable option.
Disc replacement surgery is possible because of state of the art prosthetics that have been approved by the FDA. One design of these discs is made of plastic and cobalt and has a middle core which slides back and forth giving the disc the opportunity to move when the patient's spine moves. The ends have teeth that secure them to the bones above and below the disc space. Since these same materials that make up a modern prosthetic replacement are used in other places in the body such as a replacement knee prosthetic, there is less chance that the body will reject the piece. Because there are risks inherent in replacement surgery, there will always be some fear and some anxiety about the decision to have the operation. Christians facing this operation can pray like David: "Be merciful to me O God, be merciful unto me: for my soul trusteth in thee: yea in the shadow of thy wings will I make my refuge, until these calamities be overpast." (Psalm 57:1)
Depending on the type of replacement that is used, entry to the spine is either through the front or the back. If entrance is gained through the front, the organs of the patient are gently moved aside so the surgeon gets a good look directly at the area in which the disc replacement surgery will take place. This kind of surgery may mean that there will be the possibility of a number of possible side effects from this operation. Some of these include spinal cord damage, bleeding, bladder problems and infection. Disc replacement surgery patients are usually in the hospital for between one and four days and rehabilitation will begin during that time.
Because there are more patients who have disc replacement surgery for lower back issues than cervical issues, there is less information on its benefits for cervical spine issues. In many ways, the information on replacement surgery for cervical anomalies is still somewhat sketchy, although there are smaller prosthetics designed for the neck spinal area. The decision to have such surgery, either for lumbar or cervical cushion replacement should not be taken lightly. The patient should do as much reading as possible and not rely solely on the physician's recommendations. If need be, seek a second or third opinion on the recommendation until one is comfortable with the final decision, whatever that might be. Be it fusion surgery or replacement surgery, there is help on the way for that chronic spinal pain.
A physician treating someone who has a degenerative disc condition will always attempt first to treat the pain and the condition with anti-inflammatory medicines, physical therapy and epidural steroid injections. But often those conservative procedures don't bring the kind of relief that the patient needs for a normal lifestyle. In that case, the options facing the patient and his surgeon may be limited to bone fusion or if possible, disc replacement surgery. The fusing of vertebrae bones has long been the standard operating procedure (no pun intended) for surgeons following the removal of a damaged cushion. If the surgeon recommends fusion, a bone will be grafted to the empty space on either side of the vertebrae and the bones will eventually grow together. The goal is to stop any abnormal movement that the empty space might be subject to without the disc in place. The bone will either come from the patient or from a graft from a bone bank.
The problem with fusion is the issue of range of motion that may be quite limited by the fusion operation. This may be particularly true if the disc is in the cervical area of the spine. That is the area near the shoulder and neck area. There are a number of risks that are associated with fusion surgery such as the two segments not fusing together. Additionally, there is the possibility that the vertebrae nearest the fusion location will develop problems, usually years later. The surgeon performing the disc replacement surgery will no doubt talk about the possibility of blood loss and infection with the fusion surgery as well as the risk of damage to the spinal cord in rare cases. Because of all these risks there has been an intense push by major medical prosthetic companies to develop artificial discs to replace those that have failed in one way or another and these artificial substitutes for the real thing have made disc replacement surgery a viable option.
Disc replacement surgery is possible because of state of the art prosthetics that have been approved by the FDA. One design of these discs is made of plastic and cobalt and has a middle core which slides back and forth giving the disc the opportunity to move when the patient's spine moves. The ends have teeth that secure them to the bones above and below the disc space. Since these same materials that make up a modern prosthetic replacement are used in other places in the body such as a replacement knee prosthetic, there is less chance that the body will reject the piece. Because there are risks inherent in replacement surgery, there will always be some fear and some anxiety about the decision to have the operation. Christians facing this operation can pray like David: "Be merciful to me O God, be merciful unto me: for my soul trusteth in thee: yea in the shadow of thy wings will I make my refuge, until these calamities be overpast." (Psalm 57:1)
Depending on the type of replacement that is used, entry to the spine is either through the front or the back. If entrance is gained through the front, the organs of the patient are gently moved aside so the surgeon gets a good look directly at the area in which the disc replacement surgery will take place. This kind of surgery may mean that there will be the possibility of a number of possible side effects from this operation. Some of these include spinal cord damage, bleeding, bladder problems and infection. Disc replacement surgery patients are usually in the hospital for between one and four days and rehabilitation will begin during that time.
Because there are more patients who have disc replacement surgery for lower back issues than cervical issues, there is less information on its benefits for cervical spine issues. In many ways, the information on replacement surgery for cervical anomalies is still somewhat sketchy, although there are smaller prosthetics designed for the neck spinal area. The decision to have such surgery, either for lumbar or cervical cushion replacement should not be taken lightly. The patient should do as much reading as possible and not rely solely on the physician's recommendations. If need be, seek a second or third opinion on the recommendation until one is comfortable with the final decision, whatever that might be. Be it fusion surgery or replacement surgery, there is help on the way for that chronic spinal pain.
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