Disc Replacement for Low Back Pain

The evolution of disc replacement surgery may help select patients who have chronic low back pain. However, choosing which type of patient this procedure will benefit is still being investigated. Also, several long-term concerns about the resiliency and longevity of these disc replacements have not been thoroughly examined. A physiatrist is a medical specialist who can provide you with a broad perspective on various surgical and nonsurgical treatment options for chronic low back pain.

Studies show:

• Surgical treatment for end-stage arthritic joints (such as the knee, hip, and shoulder) with joint replacement is effective in reducing pain and improving quality of life.

• Bringing similar concepts for disc replacement to spine care is becoming a reality.

• Ongoing studies in Europe show that lumbar disc replacement can help reduce pain and preserve motion in some patients.

• Several company-sponsored trials around the United States are ongoing to assess disc replacement for patients with disc-related back pain.

• In the United States, long-term benefits for disc replacement have not been demonstrated.

• Studies in the United States focus on single level disc replacement only. Multilevel disc replacement has not been studied at this time.

What you should know:

• The US Food and Drug Administration approved the first artificial disc replacement for use in the United States in October 2004.

• There are various types of disc replacement devices. The one that has been approved by the FDA has a polyethylene core lying between two metal plates.

• Like any other new technology, the indications for its use are currently very limited. Disc replacement is an option only for patients with specific disc abnormalities.

• Complications can arise from this procedure that can cause long lasting negative effects.

• Disc replacement at this time should only be considered after all other treatment attempts for low back pain have been exhausted. Even then, this type of surgery will not be appropriate for the majority of patients with chronic low back pain.

What you can do:

• A physical medicine and rehabilitation physician (physiatrist) who is expert in non-surgical management of low back pain can evaluate you and investigate all of your options for treatment of low back pain. This may include: medications, therapeutic and aerobic exercise, manual medicine, bracing, and injections. Treatment is tailored to your specific needs.

• If all options for conservative care have not helped, seeking a surgical opinion may be your next option. Your physiatrist is a good referral source for a surgical spine specialist.