The intervertebral discs separate the spine's bones, or vertebrae. The discs facilitate spine flexibility and cushion the vertebrae. Over time, the intervertebral discs stiffen and flatten. Degenerative disc disease describes the condition in which changes in the intervertebral discs cause back pain and other nerve-related symptoms. Degenerative disc disease surgery is option for a small percentage of people with persistent severe symptoms.
Indications
Degenerative changes of the intervertebral discs are part of aging, reports orthopedic surgeon and spine specialist Peter Ulrich Jr. on the medical information website Spine-Health. Most people with degenerative disc disease experience improvement in their symptoms over time. For people who experience severe pain that disrupts their daily activities and fails to respond to all other forms of treatment, degenerative disc disease surgery might be an option.
Discectomy with Spinal Fusion
Discectomy with spinal fusion is commonly recommended for the 1 to 3 percent of people with degenerative disc disease who are surgical candidates, notes the orthopedic information website eOrthopod. The intervertebral disc causing pain is removed with a surgical procedure called a discectomy. The surgeon then fills the space once occupied by the disc with bone. A permanent immobilizing device holds the vertebra on either side of the discectomy in place while the bone graft grows and connects, or fuses, them in the months following surgery. Cedars-Sinai Medical Center notes that surgeons can perform a discectomy with spinal fusion through the abdomen or by making an incision over the spine.
Disc Replacement
Artificial disc replacement surgery for degenerative disc disease is an alternative to discectomy with spinal fusion for a select group of patients, reports the American Academy of Orthopaedic Surgeons. Surgeons perform the procedure through the abdomen, removing the damaged disc and replacing it with an artificial disc. Unlike a spinal fusion, which limits the mobility of the fused vertebrae, disc replacement surgery enables continued mobility at the site of the artificial disc.
Potential Complications
Potential complications of spinal fusion surgery include nerve or blood vessel damage, bleeding, operative site infection, blood clots in the legs and fusion failure, reports the American Academy of Orthopaedic Surgeons. People with a fusion failure might require a second surgery to insert additional bone graft material.
Potential complications of artificial disc replacement surgery are similar to those of spinal fusion, with the exception of fusion failure. Problems with the artificial disc or the unintended development of bony fusion between the vertebrae to either side of the artificial disc may occur in a small percentage of patients, notes eOrthopod.
Outcomes
Spinal fusion and disc replacement surgeries are undertaken to relieve the pain associated with degenerative disc disease. Although most patients undergoing these procedures experience improvement, some do not. Approximately 50 percent to 80 percent of patients report satisfactory improvement in their level of pain after spinal fusion surgery, reports Dr. Jeffrey Spivak on the website Spine-Health. Spivak adds that no evidence suggests superior pain outcomes with artificial disc replacement surgery compared to spinal fusion.
References
- Spine-Health: What is Degenerative Disc Disease?
- eOrthopod: Lumbar Degenerative Disc Disease
- Cedars-Sinai Medical Center: Anterior Lumbar Interbody Fusion
- Cedars-Sinai Medical Center: Posterior Lumbar Interbody Fusion
- American Academy of Orthopaedic Surgeons: Artificial Disk Replacement in the Lumbar Spine
