When Is Surgery Appropriate for Degenerative Disc Disease?
Deciding whether or not to have surgery for degenerative disc disease is an elective decision.
No one ever died from having severe degenerative disc disease (DDD), so in that regard it is similar to arthritis.
Who gets DDD? Typically it is patients between the ages of 25 to 60.
During those years, the disc spaces begin to lose fluid and as a result, the disc may experience some fraying and loss of height.
If the outer portion of the disc experiences irritation from these issues, it may hurt.
The only part of the disc that contains nerve endings and is able to feel pain is the outer portion, which is called the annulus fibrosus.
When patients are suffering from degenerative disc disease, the nonsurgical options consist of: 1.
Benign neglect 2.
Physical therapy 3.
Chiropractic Treatment 4.
Spinal Decompression Treatment 5.
Interventional Pain Management 6.
Pain Medication 7.
Bracing and TENS units Nonoperative treatment is successful over 75% of the time.
Patients are often able to reach a state of acceptability with regards to their pain level and are able to avoid surgery.
One of the best treatments that have been shown in research studies is aerobic activity.
This may include swimming or cycling.
If a patient tries considerable conservative treatment for over six months and the pain is unbearable, it may be time to start considering surgery.
The North American Spine Society has listed this as a recommended prerequisite, and it may be that even a longer period of time may allow the patient to start obtaining relief.
If surgery is being debated, this decision should not be taken lightly.
Although it's highly debated, if consideration for degenerative disc surgery is in the mix then a discogram should be accomplished.
This procedure may be able to tell if the disc is the source of the pain.
If the patient has one level positive on the discogram and all imaging studies point to that same level as having significant degeneration, then surgery may have a high level of success.
In fact, it may be a life changing "home run.
" But this is not always the case as even if the diagnosis is presumed and a technically perfect surgery is performed, the patient may end up with residual pain.
Getting rid of 100% of a patient's back pain is typically unreasonable.
One should expect with a one level DDD and a great surgery performed to be able to alleviate 50 to 75% of the pain.
Surgery for degenerative disc disease, at this point in time, consists of two options.
One is to perform a spinal fusion, the second is an artificial disc replacement.
Artificial disc replacement became FDA approved back in 2004 for the lumbar spine, and the hope was it would be a veritable "holy grail" for degenerative disc disease.
So far, that has not been the outcome.
Results have been approximately 70% good to excellent for either procedure.
But artificial disc replacement surgery has not been shown to be superior yet to spinal fusions.
Based on the fact that neither surgery has a success rate over 90% (more like 70%), patients should think long and hard prior to surgical intervention
No one ever died from having severe degenerative disc disease (DDD), so in that regard it is similar to arthritis.
Who gets DDD? Typically it is patients between the ages of 25 to 60.
During those years, the disc spaces begin to lose fluid and as a result, the disc may experience some fraying and loss of height.
If the outer portion of the disc experiences irritation from these issues, it may hurt.
The only part of the disc that contains nerve endings and is able to feel pain is the outer portion, which is called the annulus fibrosus.
When patients are suffering from degenerative disc disease, the nonsurgical options consist of: 1.
Benign neglect 2.
Physical therapy 3.
Chiropractic Treatment 4.
Spinal Decompression Treatment 5.
Interventional Pain Management 6.
Pain Medication 7.
Bracing and TENS units Nonoperative treatment is successful over 75% of the time.
Patients are often able to reach a state of acceptability with regards to their pain level and are able to avoid surgery.
One of the best treatments that have been shown in research studies is aerobic activity.
This may include swimming or cycling.
If a patient tries considerable conservative treatment for over six months and the pain is unbearable, it may be time to start considering surgery.
The North American Spine Society has listed this as a recommended prerequisite, and it may be that even a longer period of time may allow the patient to start obtaining relief.
If surgery is being debated, this decision should not be taken lightly.
Although it's highly debated, if consideration for degenerative disc surgery is in the mix then a discogram should be accomplished.
This procedure may be able to tell if the disc is the source of the pain.
If the patient has one level positive on the discogram and all imaging studies point to that same level as having significant degeneration, then surgery may have a high level of success.
In fact, it may be a life changing "home run.
" But this is not always the case as even if the diagnosis is presumed and a technically perfect surgery is performed, the patient may end up with residual pain.
Getting rid of 100% of a patient's back pain is typically unreasonable.
One should expect with a one level DDD and a great surgery performed to be able to alleviate 50 to 75% of the pain.
Surgery for degenerative disc disease, at this point in time, consists of two options.
One is to perform a spinal fusion, the second is an artificial disc replacement.
Artificial disc replacement became FDA approved back in 2004 for the lumbar spine, and the hope was it would be a veritable "holy grail" for degenerative disc disease.
So far, that has not been the outcome.
Results have been approximately 70% good to excellent for either procedure.
But artificial disc replacement surgery has not been shown to be superior yet to spinal fusions.
Based on the fact that neither surgery has a success rate over 90% (more like 70%), patients should think long and hard prior to surgical intervention