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 A typical patient profile |
A typical example of a disc prosthesis treatment.
Complaints- Security employee, 38 year male
- Has already had a hernia operation at L4/L5 with temporary improvement only
- No indication for a new hernia operation or another decompression
- More than 6 years severe constant lower back pain
- Intermittent leg pain, but back pain dominates
- Pain scores back= 2 leg right=9 leg left = 9 (0=bad; 10=pain free)
- Standing and sitting is very painful
- Can't work without pain
- Suffers from painful restrictions in activities daily life (ADL)
- Pain treatment doesn't help enough
- No nerve entrapment symptoms
- No indications for mental problems
- Doctor said: accept the pain
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Findings- Physical exam showed no numbness of special deviations
- The normal X-rays shows two narrowed bottom discs
- Actually, the normal X-ray suits entirely his age
- MRI: the two bottom discs have dried out
- MRI: no new hernia or nerve root entrapment is visible
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Discography (memory pain test of discs)During discography level L5/S1 seems to have deviations, but seems painless
The discographic research does confirm that the pain is caused by L4/L5
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TreatmentOnly the disc which was symptomatic during the pain test has been replaced with a artificial disc prosthesis via the abdominal approach. |
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Post operative treatment and resultsSpecial rehabilitation was not necessary
Support through soft bandage during daytime
6 weeks after the operation the patient resumes his daily activities
The pain and restrictions have disappeared
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Does it always go like this?It does not always go like this. There are patients where an artificial disc prosthesis did not relief the pain. Complications are mostly under control and can generally be solved. Rarely a second intervention is necessary, such as decompression of the nerve root at the back side. Seldom a second way of defence is needed with an additional stabilization surgery performed via the back or the abdomen.
The results are depending on the diagnosis, age and implantation technique: the less spine deviation, the higher the chance of success. It is possible that other hidden and less evident problems play an important part. Extremely seldom implantation cannot be performed, because of technical reasons such as unexpected poor bone quality. At that moment a fusion is the alternative. |
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