Surgical Option for Treating Degenerative Disc Disease
What is Degenerative Disc Disease?
Degenerative disc disease is a condition in which the discs, located between the individual vertebra, deteriorates and break down. The discs no longer provide support between the vertebrae, which leads to pain and other symptoms.
Surgery for Degenerative Disc Disease
Surgery is not an option often used for degenerative disc disease. Individuals must have undergone at least 6 months of other treatments that have not helped with the pain, have disc degeneration at just 1 or 2 levels, and be judged by a surgeon to be appropriate for the procedure.
Question to Ask The Doctor Prior To Surgery
Questions an individual may wish to ask their doctor prior to surgery include:
- Why is the surgeon recommending this approach?
- What are possible alternatives to surgery?
- What happens if the individual chooses not to have the surgery?
- What are the risks and benefits of the surgery?
- How long is the recovery time?
- What is required of the individual to recover after surgery, ie. physiotherapy?
- How will the individual’s pain be managed after surgery?
- What would be considered a successful outcome?
- What are the long-term consequences of the surgery?
- How many of these procedures has the surgeon done?
- What is the surgeons success rate with the specific procedure?
Types of Surgeries for Degenerative Disc Disease
There are three main types of surgery that can be done for degenerative disc disease. Decompression surgery a procedure in which tissue that is putting pressure or pressing on a nerve is removed. Stabilization surgery or a fusion is a technique where 2 or more vertebrae are joined together. Artificial disc replacement or intervertebral disc arthroplasty involves the removal of a degenerated disc which is replaced by an artificial disc.
Spinal Decompression Surgery
Spinal decompression surgery is a term that refers to any surgery or procedure that intends to relieve symptoms that are caused by pressure on the spinal cord or nerve roots. The risk associated with this surgery include: infection, bleeding, blood clots, and nerve or tissue damage.
Type of decompression surgery include:
- Facetectomy: a procedure in which a facet joint is removed to reduce pressure
- Foraminotomy: a procedure in which the exit through which a spinal nerve leaves the vertebra (foramin) is made larger
- Laminectomy: a procedure in which the bony plate at the back of the vertebra (lamina) is removed
- Laminotomy: a procedure in which a larger opening is made in the laminia
- Discectomy: a procedure in which part or all of a disc is removed
- Corpectomy (Vertebrectomy): a procedure in which the entire vertebra is removed
Spinal Fusion Surgery
Spinal fusion surgery is when two or more vertebrae are fused together preventing any motion between the vertebrae. This surgery is used to treat deformities of the spine, spinal instability, or herniated discs.
During the procedure, the doctor will place bone or bone like material between the two vertebrae to be fused. Metal plates, rods, screws, and cages may be used to hold the vertebrae together while the are fusing, so they can heal into one solid unit.
The risk associated with this surgery include: infection, bleeding, blood clots, poor wound healing, nerve or tissue damage, and pain from the site of a bone graft (if the individual’s own bone is used).
Artificial Disc Replacement Surgery
Artificial disc replacement or intervertebral disc arthroplasty is a procedure in which a degenerated disc is surgically removed and replaced with an artificial disc. The disc replacement surgery may be used in place of a spinal fusion in some cases, individuals should talk with their surgeon to see if this is possible for them.
The risk associated with this surgery include: infection, bleeding, blood clots, dislocation of the artificial disc implant, implant failure or fracture, loosening of the implant, poor placement of the implant, spinal stenosis, and stiffness or rigidity of the spine.
In some cases, an individual may require emergency surgery. If an individual is experiencing severe lower back pain along with weakness in the legs, pain traveling along the legs to the feet, and bladder or bowel incontinence, they should seek medical attention immediately. This could be Cauda Equina syndrome, a serious disorder that requires immediate intervention.