Degenerative, bulging, and herniated discs are prevalent causes of chronic back and neck pain. Whereas the pain can improve with time, it may require treatment if it persists. Disc replacement surgery is an effective treatment for back and neck pain. However, it is an invasive, major surgery that requires a long recovery and comes with various risks.
Fortunately, several alternative treatments exist, which you can explore for your neck and back pain if you do not want to undergo disc replacement. Knowing what alternative procedure would suit your needs depends on what precisely is causing your pain. In given cases, there could be more than one option.
At Dr. George Rappard Facility, we can help you learn more about the various treatment alternatives available to restore spinal function and structure and alleviate neck and back pain. We also boast expert healthcare providers who administer these treatments to patients looking for them in Los Angeles. If you need treatment, do not hesitate to contact us for a consultation.
What Is Disc Replacement?
Disc replacement is a form of spine or back surgery. Your spinal cord is composed of bones known as vertebrae stacked onto each other. Discs between vertebrae function like cushions and enable the bones to move and rotate without rubbing against one another. The discs and lumbar vertebrae are located at the bottom of the spinal cord.
Disc replacement surgery entails replacing a degenerated or worn disc in the lower part of the spinal cord with an artificial disc made of a combination of plastic and metal or pure metal. This is a major procedure that requires staying at the hospital. It also necessitates the administration of general anesthesia.
Why You May Need Disc Replacement
Disc replacement surgery is primarily required to cure low back pains. Still, only some people suffering from low back pains are eligible for this procedure. Your physician will have to conduct some tests on you to determine if it is fit for you. Generally, your doctor may recommend disc replacement surgery if:
- You do not have scoliosis or any other spinal deformity.
- You have not had spinal cord surgery before.
- You do not have excessive weight.
- You do not have significant joint disease or compression on your spinal cord nerves.
- Your back pains mainly originate from one or two discs in your lower back.
Alternatives to Disc Replacement
Although disc replacement surgery has a high success rate, various people prefer its alternatives for different reasons. For one, there are conditions for which disc replacement may not be suitable. Fortunately, most of the options have recorded remarkable results. Your doctor will assess your signs and symptoms and advise on the appropriate disc replacement surgery alternative that best suits your condition. Effective, commonly-conducted disc replacement alternatives are:
Spinal fusion is a surgery to connect two or several bones in the spinal cord. Connecting the bones prevents movement between them, and preventing movement prevents pain. During the procedure, the surgeon places bone or bone-like material in the space between two vertebrae. Rods, screws, or metal plates may hold the vertebrae together. They can then fuse and heal as a single bone.
The procedure lasts four to six hours based on the patient's condition and specific needs. Once it is over, you will recuperate in a hospital room, with the doctor observing how you respond to medication. A physiotherapist can assist you in walking after the procedure. The doctor will do an ex-ray to ensure you are okay before they discharge you.
Spinal fusion and disc replacement are spine surgeries done to achieve the same goal, but they are conducted differently. Whereas disc replacement entails replacing the injured disc with an artificial one, spinal fusion corrects spinal damage by fusing two or more bones to decrease motion that may result in pain and enhance stability. That said, spinal fusion can be a disc replacement surgery alternative, and vice versa is also true. However, the disc replacement surgical procedure has more advantages when compared to the spinal fusion surgery.
Stem Cell Therapy
Stem cell therapy entails taking the patient's autologous healthy cells from two sites and re-injecting them into the affected area. This therapy is aimed at promoting healing in the injured area.
Based on your specific condition, your physician may conduct any of these two forms of stem cell therapies:
- BMAC (Bone Marrow Concentrate)— here, the physician removes highly concentrated cells from your bone marrow and re-injects them into the affected spinal location to enhance healing.
- MMAT (Minimally Manipulated Adipose Tissue Transplant)— here, the doctor extracts the cells from your fat (adipose) tissue, processes them, and reinjects them into the injured spinal location. The primary benefit of this process is the physician can do it at several sites during the same procedure.
These processes last approximately one hour and thirty minutes to two hours. The doctor utilizes ultrasounds and x-rays to locate the specific injury site. You are likely to leave the hospital a few hours after the procedure.
Stem cell therapy is minimally invasive and can drastically alleviate low back pains while substantially reducing the recovery time and risks associated with disc replacement. The back injection the doctor administers into the damaged disc during stem cell therapy may repair damaged disc cartilage, improve disc height and hydration, and reduce painful inflammation.
Stem cell therapy for back pains is an excellent disc replacement alternative when there is no large disc herniation and instability in the spinal cord. However, it is not recommended for spinal spondylolisthesis, scoliosis, and stenosis patients. Stem cell therapy for minor disc herniations, facet arthritis, and degenerative disc disease (DDD) can dramatically decrease the days lost to disability. The patient can return to recreation and work more quickly.
Annuloplasty or Intradiscal Electrothermal Coagulation (IDET)
Intradiscal Electrothermal Therapy (IDET) is also a less invasive disc replacement surgery alternative. It helps treat DDD in the lower back for patients who do not want to undergo disc replacement or fail conventional treatment.
During the IDET procedure, the surgeon inserts a needle into the disc space, passes a catheter through the needle, and heats the annulus. It remains unclear how exactly this procedure alleviates pain. But according to theory, the heat thickens and contracts disc collagen fibers, sealing up painful cracks and tears and relieving pain. This procedure additionally cauterizes the nerve endings, making them minimally sensitive.
Not every patient benefits from annuloplasty. The treatment will likely help patients with mild DDD more than patients with progressed disc degeneration. Annuloplasty is a minimally invasive outpatient procedure conducted under local anesthesia and mild sedation. Even though this is a minimally invasive procedure, it is unpopular due to its minimal clinical efficacy.
Epidural Steroid Injections (ESIs)
ESIs are a non-surgical method of eliminating pain or discomfort caused by spinal stenosis, disc herniation, or nerve compression. The doctor can administer the injections into your lumbar region to alleviate leg and lower back pain by reducing the inflammation causing nerve compression.
ESIs also work perfectly on the neck area (cervical spine) and alleviate the pain that may impact the shoulders, arms, neck, and middle and upper back. ESIs treat inflammation and reduce swelling in the sites they are administered. This makes them a non-invasive disc replacement alternative to treating back pains that require minimal recovery time.
But based on what is causing your back pains, ESIs are not always effective for long-lasting pain relief. Thus, you must undergo a comprehensive examination to know whether this procedure suits you.
Posterior Dynamic Stabilization
Posterior dynamic stabilization is a distinctive disc replacement alternative meant to mobilize and stabilize the spinal cord and its movement while alleviating pressure in the painful vertebral disc to minimize pain and promote healing in the spinal cord.
The doctor utilizes different modern devices to unload pressure from the spinal cord, just similar to how a moveable (dynamic) brace removes pressure from a hurt knee or ankle to enable it to heal. Various types of posterior dynamic stabilization tools are still early in use or are in the testing or investigative phase; thus, their potential risks, complications, and efficacy are yet to be established.
Like all treatments, posterior dynamic stabilization poses risks like adjacent vertebral segment disease, implant loosening, spinal infection, dural tear, and implant breakage, although they rarely happen.
Endoscopic Spine Surgery (ESS)
Also referred to as endoscopic lumbar discectomy, ESS is minimally invasive and aims at relieving pain experienced in the lower back and leg. The surgeon inserts an endoscope with an HD camera attached to it into the spinal cord from the lumbar region through a quarter an inch cut. The surgeon determines the primary cause of the pain in the spine and extracts the herniated disc from the lumbar region. This alleviates pressure from the spine and nerves.
Per most clinical research, endoscopic spine surgery has several benefits, like short recovery time, minimal damage to the soft tissue, and less pain. Additionally, it has a lower chance of complications than disc replacement.
Platelet-Rich Plasma Therapy (PRP)
During PRP, the doctor draws a blood specimen from the patient, isolates platelets from the sample, processes the platelets, and then re-injects them into the injury area, in this case, the spinal cord.
Platelets are the components that promote healing in our bodies and act as the first line of defense. They perform three primary functions— releasing growth elements to enhance the generation of new tissues, attracting healing components from the blood, and producing a web-resembling scaffolding known as fibrin to promote the development of new tissues and cells.
A lot of platelets present in an injured site means quick recovery. PRP therapy is among the common disc replacement alternatives that most athletes prefer for sport-related injuries. The procedure is generally completed within forty-five years.
Endoscopic rhizotomy is a less invasive procedure that assists doctors in visualizing the medial neural structure to ablate the nerves causing pain in degenerative joint disease (osteoarthritis). This procedure alleviates the pain in the nerves, so the patient feels relief. Additionally, it maintains spine mobility for an extended period.
Endoscopic rhizotomy enables patients to live many years without experiencing pain. The procedure lasts one hour. The patient usually remains conscious during the entire operation, although in some cases, the doctor might recommend a sedative for the patient to feel more comfortable.
Endoscopic rhizotomy is highly successful. The patient might resume their everyday life within seven or fourteen days. This surgical procedure also has long-lasting pain relief effects and fewer complications.
Coflex Lumbar Interlaminar Device
The coflex lumbar interlaminar device is the best disc replacement alternative for a few patients. Coflex is a device or implant made of titanium that the doctor places in your lower back to preserve and support spine motion. This device also alleviates pressure from the arthritic joint nerves and structures.
The Coflex surgical procedure is faster than disc replacement surgery, meaning patients do not have to stay admitted for weeks after the procedure. The recovery period is also shorter. The surgery offers long-lasting pain relief in many patients, although the follow-up for leg and lower back pain begins after two to five years.
However, most patients have expressed that they continue to experience pain after undergoing this procedure. Other risks of the Coflex lumbar procedure include tingling sensations or numbness in legs and arms, spinous process fractures, wound drainage, and infections. Thus, your physician should only recommend this procedure after comprehensively diagnosing your condition.
Find Reliable Los Angeles Neurointerventional Services Near Me
Disc replacement surgery is highly effective for relieving neck and back pain and treating spine-related conditions. However, this is also a major procedure with various risks, such as blood clots in the legs, spine rigidity, implant loosening or wear, implant failure, dislocation or dislodging of the artificial disc, and infection of the artificial disc and the region surrounding it.
Additionally, it takes an extended period to recover from the surgery. On the other hand, disc replacement surgery alternatives will allow you to accomplish the same treatment goals with a short recovery period and fewer complications.
At Dr. George Rappard Facility, we offer a wide variety of alternatives for patients seeking spinal cord treatment in Los Angeles who do not want to undergo disc replacement. Our skilled healthcare providers will thoroughly analyze your condition, diagnose your symptoms, and select a treatment option that best suits your needs. Contact us at 424-777-7463 for a consultation and to learn more about our procedures.