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Do I Need Spinal Fusion or a Disc Replacement?

Do I Need Spinal Fusion or a Disc Replacement?

A herniated disc may be a pain in the … back. Otherwise called a “bulging” or “slipped” disc, the problematic tissue may cause no symptoms, but it’s more likely to “pinch” or impinge upon surrounding nerves, causing a great deal of shooting or radiating pain. Fortunately, though, you have treatment options. 

At Center for Neurosurgery Las Vegas, board-certified neurosurgeon Dr. Scott Glickman and his team know just how debilitating a herniated disc can be. That’s why they offer advanced treatment options for their patients with disc problems, including two surgical ones: spinal fusion and disc replacement. Here’s what you need to know about both problems.

Your spinal structure

An adult spine contains 24 bony vertebrae. In between the vertebrae are spinal discs, made up of a hard outer shell (annulus fibrosus) and a gel-like interior (nucleus pulposus). Fibers on the annulus allow the discs to attach to the vertebrae above and below, stabilizing them.

Besides providing a physical barrier between the bones so they don’t grate on each other, the discs serve to absorb the shock when you walk, run, and jump. They’re also what allow you to bend, flex, and twist your spine. 

Discs aren’t indestructible, however. Spinal trauma can cause the annulus to rupture, allowing the nucleus to leak out into the spinal canal, the hollow tube inside the vertebrae that contains the spinal cord and cerebrospinal fluid. There, the nucleus can press against (impinge) nerve roots; the nerve protests by generating pain signals, and by causing weakness and/or numbness down an arm or leg.

Symptoms of a herniated disc

Herniated discs can happen anywhere along the spine, but they’re most common in the cervical (neck) and lumbar (lower back) regions. That’s because you move the most in these areas, and they sustain the most damage from the wear-and-tear as a result.

The most common symptom of a herniated disc is persistent pain. Pressure on a nearby nerve can create pain that’s severe and unrelenting, is usually felt on just one side of the body, and often radiates into an arm or leg. A common example of this is sciatica. When a herniation of the (lumbar) L4-L5 disc presses on the sciatic nerve, it can radiate pain all the way down into your foot.

Other symptoms that come from a herniated disc include:

A herniated disc can also lead to poor posture.

Do I need spinal fusion or a disc replacement?

Here at Center for Neurosurgery Las Vegas, we use conservative treatments, such as pain meds and muscle relaxers, physical therapy, and epidural steroid injections. For the small percentage of cases where conservative treatments fail, Dr. Glickman may recommend either spinal fusion surgery or a disc replacement to relieve the pain and pressure

What does spinal fusion do?

With a spinal fusion procedure, Dr. Glickman permanently joins two or more vertebrae, eliminating any motion between them. Fusion is usually required when part of all of a vertebra or vertebral disc needs to be removed or remodeled and when motion is the source of your pain; in essence, when you fuse the vertebrae together, you remove the movement causing the pain. The biggest drawback is that you lose some flexibility, but since the procedure involves very small parts of the spine, it doesn’t usually present a significant problem.

Dr. Glickman only suggests spinal fusion when he can clearly identify the underlying source of your pain using imaging tests. Those with the following back issues may benefit from spinal fusion:

For each case, the loss of some movement is deemed acceptable in exchange for diminished pain.

What does disc replacement do?

Disc replacement surgery removes the offending disc and replaces it with an artificial one, relieving pain while preserving your ability to move normally. Dr. Glickman may choose to perform a microdiscectomy instead, a minimally invasive procedure to remove just the part of your disc that’s impinging on the nerve.

Dr. Glickman generally recommends disc replacement if you:

To determine if you’re a good candidate for disc replacement, Dr. Glickman requires tests such as a discography, a magnetic resonance imaging (MRI) scan, and/or an X-ray.

If you’re dealing with back pain, it’s time to come into the Center for Neurosurgery Las Vegas for an evaluation and possible treatment. Give us a call at 702-929-8242 to set up a consultation with Dr. Glickman, or book online with us today.

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