Disk replacement: An effective treatment for low back pain?

Is disk replacement surgery an effective treatment for low back pain?

- No name / Virginia

Mayo Clinic neurologist Jerry Swanson, M.D., and colleagues answer select questions from readers.

Answer

The usefulness of disk replacement surgery in treating chronic low back pain is still a topic of considerable debate.

Some research suggests that lumbar disk replacement may reduce back pain due to degenerative disk disease with fewer complications and a shorter recovery time than other forms of back surgery, such as spinal fusion. However, more research is needed to evaluate the long-term safety and effectiveness of lumbar disk replacement.

Spinal fusion has long been considered the most effective treatment for low back pain caused by degenerative disk disease. In this procedure, the damaged disk is removed and the adjoining vertebrae are fused together by bone grafts and metal devices secured by screws. Although spinal fusion reduces pain, it results in some loss of flexibility in the spine and requires a long recovery.

Disk replacement is a relatively new treatment option for degenerative disk disease. In this procedure, the damaged disk is removed and replaced with a metal and plastic disk. Disk replacement appears to be as effective as spinal fusion in relieving low back pain. However, as with all emerging treatments, the indications for its use are still very limited.

Ideal candidates for disk replacement surgery:

Are between the ages of 20 and 60 years
Have only one degenerated disk
Have failed to respond to other forms of treatment

Disk replacement surgery isn't recommended for people who have systemic bone disease, such as osteoporosis, or who have had previous back surgery, including spinal fusion.

It's important to note that disk replacement surgery is more difficult than spinal fusion surgery. Also, the risks of removing the artificial disk if it fails or becomes infected are potentially serious.