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Is it Time for a Second Opinion?

Often times, patients suffering from back and/or neck pain are told the only option they have is an invasive procedure, like a spinal fusion. It's crucial that patients seek second opinions, especially when told to go down a more-invasive treatment path. While DISC strictly follows a conservative care strategy, where the least invasive modalities are deployed first, some other groups are not as adherent to conservative treatment.

If you are among the thousands suffering from chronic pain and limited mobility, it may be time to schedule a second opinion. Less invasive procedures (like pain blocks) often help patients overcome their pain with easier recoveries; and for more severe spine cases, artificial disc replacements (ADRs), also referred to as TDRs (total disc replacements), can solve patients' pain without the long recovery times associated with more invasive spine procedures.

Here's some info about artificial disc replacements from of our leading specialists:

Video: What is an Artificial Disc Replacement?


1. Is Surgery the Best Option?

The first consideration is whether surgery is your best option. Treatment will depend on the severity of your condition, so let's explore two of the more common disorders that may require spine surgery.

Degenerative Disc Disease: As we age, the discs between our vertebrae, which normally provide cushion, support, and range of motion, naturally degenerate. For many people, this happens simply as a consequence of aging and causes no pain or loss of mobility, but for others, the degeneration of discs in the cervical or neck region can lead to numbness and tingling in the arms, pain radiating down the arms, and even loss of function.

Disc degeneration can result from dehydration within the disc, traumatic injury, a loss of collagen, or arthritis, and can lead to our next condition, herniation.

Disc Herniation: If the disc degenerates or is injured, it can leak its contents into the surrounding space, putting pressure on nerves, or the spinal cord, resulting in many of the same symptoms as a degenerative disc, namely pain, numbness, and tingling in the limbs. Because the bones of the neck are smaller than those of the chest and lower back, and have smaller openings for nerves to pass through, leakage from cervical discs results in more severe symptoms than leakage in the thoracic or lumbar regions.

Whether you suffer from disc degeneration, herniation, or both, there are many non-surgical treatment options to consider before resorting to surgery. Many cases resolve on their own and can be managed with pain and anti-inflammatory medications. Non-surgical modalities such as epidurals and facet blacks may be considered. Physical therapy is also an option, as is the use of hot/cold therapy, but for cases that don't respond to treatment, surgery becomes the natural option. Either way, patients ought to schedule a second opinion to confirm whether or not surgery is right for them.

2. Artificial Disc Replacement Surgery vs. Fusion

There are two primary surgical procedures to correct spinal disc conditions:

  • Disc removal and replacement, using a synthetic product that mimics the original disc.
  • ACDF surgery (anterior cervical discectomy and fusion), where the disc is removed and replaced using a bone graft. The graft can come from the patient (autograft), from a cadaver donor (allograft), or be a synthetic replacement (plastic, ceramic, titanium, or bioresorbable compounds).

Artificial disc replacement has several advantages over ACDF. First, it preserves mobility of the neck, which is lost when the bones are fused during ACDF. And because the discs want to move with artificial disc replacement you are not required to wear a collar or a brace which may be required after a fusion operation. One of the most devastating complications of ACDF is failure of the graft to heal properly resulting in non-union of the bone and potentially requiring further surgery. Because the bones do not have to heal, artificial discs do not produce complications. Also, in the case of allografts, patients can suffer from pain and soreness in the graft area (typically the hip). Your doctor will decide which procedure is best for your condition.

Risks involved with ADR are typical of any surgical procedure: infection, which is why you should choose a facility with a reputation for exceptional cleanliness; pain at the site of operation; and the possible need to replace the synthetic disc over time (similar to hip or knee replacements).

3. What Results Can You Expect?

Results depend on the treatment path you and your specialist decide on. With less invasive procedures, such as pain blocks, patients can expect quicker recoveries. Even with artificial disc replacement surgery, however, patients should expect a faster recovery than they'd otherwise expect: many patients are back to doing the things they'd normally do pre-back pain only a few months after their surgery.

Video: Artificial Disc Replacement Patient Testimonial


4. Choosing Your Surgeon

The most important aspect to spine care is who your specialist is. You want someone who specializes in conservative care; someone who has the background, experience, and training to afford you the best possible outcome. Board certification and fellowship trained is a must, as is an integrative facility. A facility that offers a full range of surgical, therapeutic, and rehabilitative services will guarantee continuity of care throughout your treatment and recovery period.

Get a second opinion with one of DISC's world-renowned specialists so you can have confidence going into surgery.

Video: Why Patients Chose DISC




About the author

discmdgroup DISC Sports and Spine Center (DISC) is one of America’s foremost providers of minimally invasive spine procedures and advanced arthroscopic techniques. Our individually picked, highly specialized physicians apply both established and innovative solutions to diagnose, treat, and rehabilitate their patients in a one-stop, multi-disciplinary setting. With a wide range of specialists under one roof, the result is an unmatched continuity of care with more efficiency, less stress for the patient, and a zero MRSA infection rate. Read more articles by discmdgroup.

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