The short answer
The ideal candidate has pain caused by one or two worn or herniated discs, reasonably healthy joints behind those discs, good bone quality, and symptoms that haven't improved after several months of non-surgical care.
Pain that comes from the disc
Discs are the cushions between the vertebrae. With age, injury or repetitive strain they can dry out, tear or bulge. When a damaged disc is the main source of pain, or presses on a nerve root or the spinal cord, replacing it can address the cause directly.
In the neck, this often shows up as arm pain, tingling or weakness. In the lower back, it's often a deep, activity-related ache, sometimes with pain running into the legs.
Healthy structures around the disc
An artificial disc restores motion, so the rest of that spinal segment needs to be able to move well. The small facet joints at the back of the spine should be free of significant arthritis, and the bones should be strong enough to hold the implant. A bone density scan may be recommended if there's any doubt.
Conservative care has had a fair chance
Most people with disc pain improve without surgery. Physical therapy, anti-inflammatory medication, activity changes and targeted injections are usually tried first. Surgery becomes a reasonable conversation when these haven't helped enough after several months, or sooner if there is progressive weakness or signs of spinal cord compression.
When fusion may be the better choice
Disc replacement isn't right for everyone. Significant facet arthritis, spinal instability or slippage, osteoporosis, infection, or disease across many levels usually point toward fusion or another approach. A good surgeon will tell you plainly which operation fits your spine.
Next step
If you've been told you need a fusion, or you're living with disc pain that hasn't improved, call us to arrange a consultation or an imaging review with Dr. Garber.
Signs you may be a candidate
- Neck pain that won't settle, with or without pain, tingling or weakness in the arms
- Low back pain that has lasted months, with or without pain down the legs
- Little or no relief from therapy, medication or injections
- A diagnosis of degenerative disc disease
- A herniated disc in the neck or lower back
- Pain that has come back after an earlier disc surgery
- A recommendation for spinal fusion that you'd like a second opinion on