Back

I have chronic low back pain from a herniated disc. I asked my surgeon about having a disc replacement. She just said that I wasn't a good candidate for that procedure. Who is?

Research is currently underway to answer this question more completely. When total disc replacement (TDR) was first approved by the FDA (2004), the implant manufacturer published a list of patients who should NOT have this operation.

Since that time, the implant devices have improved. The surgical technique used has also improved. Surgeons are getting better results now than in the beginning. This means more patients may be included in those who are considered good candidates for the procedure.

The most common use of TDR is for patients with degenerative disc disease. Anyone with disc herniation or protrusion is usually treated conservatively before even considering surgery. If severe, disabling pain persists, then a microdiscectomy may be done.

In this operation, a small incision is made and a special surgical scope is passed through the opening into the spine. The scope has a tiny TV camera on the end. Pictures broadcast on a TV screen allow the surgeon to see the spinal structures as the operation is done. Part or all of the disc is removed.

TDR may be used for patients who would otherwise be having a spinal fusion. The implant preserves the disc space and disc height while maintaining motion at affected the spinal segment.

Each surgeon makes his or her own criteria for inclusion or exclusion for TDR. You may have to ask your surgeon more specifically why you don't qualify.

« Back