Deciding on Surgery for Degenerative Disc Disease

Deciding on Surgery for Degenerative Disc Disease

Everyone’s discs degenerate as we get older. Disc degeneration can also be seen as early as the late teens as a result of trauma, surgery, or just bad genetics. Most people with degenerative disc disease can manage their ongoing pain, as well as more painful flare episodes, with conservative (non-surgical) care.

Yet, for a small percentage of patients surgery may become the right option because conservative degenerative disc disease treatment has not worked well, and their severe pain and muscle spasms make it difficult to function normally. While it is sometimes true that the pain from a degenerated disc can subside after the disc has fully degenerated, this process can take years and is highly variable.

For people with ongoing severe, disabling pain and associated symptoms (e.g., numbness, tingling, difficulty sitting) it is sometimes not possible to wait for non-surgical therapy to work and/or for nature to run its course. Consequently, surgery - either the more standard fusion surgery or the newer artificial disc replacement surgery - may be warranted if patients meet the following criteria:

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  • They have conscientiously engaged in at least six months of non-surgical pain treatment and active exercise-based physical rehabilitation for core strengthening;
    Practical point
    If back pain causes one to make concessions to his or her normal lifestyle on a daily basis, despite adequate non-operative treatments, then a surgical consultation is warranted.
  • Their pain is still significant, both in terms of magnitude and its inability to be controlled with acceptable doses of medication or treatment, and, most importantly;
  • Their ability to function in every day activities is seriously diminished. Patients may be advised to apply “the every day test”. This means that if they are making concessions to their normal lifestyle every day of their lives because of their back pain, despite adequate non-operative treatments, then a surgical consultation is appropriate.
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Dr. Jack Zigler, Orthopedic Surgeon, Plano, TX, 75093
Article written by: Jack Zigler, MD