I've heard that disc replacements are possible now. What are my chances for getting one of these?
Total disc replacement or total disc arthroplasty (TDA) is a fairly new treatment option for chronic back pain. As with any new type of surgery (especially one involving an implant) patient selection is limited.
For now, patients must be young (18 to 60 years old). There must be a good effort toward conservative (nonoperative) care. This may include antiinflammatory drugs and pain relievers. Physical therapy for pain control and an exercise program is advised before undergoing surgery. Behavioral therapy to address any social or psychologic issues is also important.
MRI scans should show evidence of pressure on the spinal cord or spinal nerves. Usually the patient's pain and other symptoms are consistent with a disc protrusion or degenerative disc disease.
There are also reasons why patients might not be included. For example, severe osteoporosis or other bone disease may put the patient at too great a risk for fracture and failure.
Orthopedic bone conditions such as scoliosis and stenosis make the patient an unlikely candidate. Pregnancy, obesity, and previous back surgery are other reasons a surgeon may not perform a disc replacement operation.
Your best bet is to see an orthopedic surgeon who performs this operation. After an examination and evaluation, the surgeon can tell you whether or not you are a good candidate for this type of treatment. If not, then alternative options can be discussed.
Eric L. Lin, MD, and Jeffrey C. Wang, MD. Total Disk Arthroplasty. In Journal of the American Academy of Orthopaedic Surgeons. December 2006. Vol. 14. No. 13. Pp. 705-714.
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