Patients who are unable to carry out their daily chores because of spine pain or are frustrated with limited physical activity may consider lumbar spinal fusion surgery for symptomatic lumbar degenerative disc disease.
Lumbar Spinal Fusion Surgery: Lumbar fusion surgery is designed to reduce the pain by stopping the motion at the segment of the spine. Depending on which level of the spine is affected, the fusion may vary. One-level fusion at the L5-S1 segment is the most likely level to break down due to degenerative disc disease. A fusion at this level of the spine does not significantly change the mechanics in the back. Fusion of the L4-L5 level removes some of the normal motion of the spine as this is a major motion segment in the lower back (as opposed to L5-S1, which has limited motion). Considered to be a major surgery, fusion surgery could be an effective option for patients to enhance their activity level and overall quality of life. This potential positive outcome is particularly true now that less invasive surgical techniques are available to decrease post-operative discomfort, maintaining more of the normal anatomy of the lower back that will result in higher rates of fusion than previous techniques.
Lumbar Artificial Disc Replacement Surgery: A novel way to treat pain and disability from lumbar degenerative disc disease is called artificial disc replacement. It replaces the disc instead of fusion the disc-space together and maintains more of the normal motion in the lumbar spine, thereby reducing the chance that adjacent levels of the spine will break down due to increased stress. The major worry with artificial disc replacement is that anything that moves can wear out with time. Many patients who undergo surgery for DDD are younger than those patients, who had used artificial joints for hips and knees. Although there is less wear and tear on a spinal joint than a major joint like a hip or knee, gradually there may be considerable risk which will lead to the replacement of artificial discs in the future. Artificial discs are placed through an anterior approach to the spine under the great vessels (aorta and vena cava). Once it's done, these vessels become scarred down onto the spine, making revisions problematic.
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