Severe disc degeneration / Symptoms
Severe disc-degeneration causes constant, sometimes immobilizing back-pain. Changes of the disc are visualised by means of an MRI and subsequently the degenerated, pain-causing disc is verified by means of Discography (see “diagnosis”). Typical symptoms of degeneration are strong, chronic back-pain and paralysis of the legs. Many patients with degeneration have had numerous hernias previously.
Alternatives to fusion:
Most clinics still prefer fusion-operations for chronic back ailments. In our opinion a fusion should only be considered, when alternatives like the endoscopic abrasion or artificial disc have failed or do not promise a good outcome. |
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Artificial Disc
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Animation of a disc prothesis operation |
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For extensive, in-depth information regarding the artificial disc replacement surgery please select: ADR.
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The procedure lasts about 1 ½ hours, the patient can leave the wake-up room two hours after, wearing a specially fitted corset. In the long term this procedure brings a distinctive alleviation or even pain-freedom, often noticeable immediately after the abrasion. The patient can be released two days after the procedure. The light corset is to be worn during the following 6 weeks, then the patient can take up physiotherapy. The abrasion is best suited for older patients with distinctive disc-degeneration. |
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Spondylodesis = Spinal Fusion
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Cage |
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Screws and plates |
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When is a spinal fusion necessary?
At the Dr. Hoogland Spine Center, all other alternatives for the treatment of chronic back-pain – like the endoscopic nucleotomy, abrasion or disc-prosthesis - are considered, prior to recommending a spinal fusion. But certain spinal conditions can only be mended by means of a spinal fusion. Particularly for patients with a spondylolisthesis or after several spine operations, the spinal fusion often means the last resort.
What does the procedure involve?
A discography determines the symptom-causing disc prior to a spinal fusion. Direct stability is achieved by applying screws, plates and, if needed, cages. In order to achieve a lasting fixation, bone-surrogates or bone from the iliac-crest are inserted, which merge with the vertebrae after approximately 4 months.
What is the success rate?
Our experience after approximately 400 fusion operations has shown that in about 75% of cases, a good to excellent result has been achieved. Major complications are rare. |
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Cage and internal fixator |
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Types of fusion:
- Cage: Degeneration of one disc. Patient has not been operated on before.
- Screws and plates: Necessary for patients with spondylolisthesis(slipping of the vertebrae)
- Cage and internal fixator: Discs have been operated on before, and there is degeneration on more than one level
Which physiotherapy and/or muscle training is necessary after a spinal fusion?
An appropriate post-operative build-up programme will be individually drawn up by our experienced physiotherapists and physicians. You can find out more under rehabilitation.
See also: Pain Therapy
General pre-operative instructions
Previous theme: Spinal Stenosis
Next theme: Chronic Backpain
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Severe disc degeneration
