For some patients with back and/or leg pain, it’s clear that surgery will be needed. What’s less clear, in most cases, is what type of surgery they need.
If this situation sounds familiar, your doctor will likely advise you on what he or she thinks is the right course of action, but it’s always to your advantage to have all the facts. I’ve helped lots of patients who are struggling to understand their options, and the decision really boils down to two questions:
- “What condition am I trying to fix?”
- “What do I want my surgery to accomplish?”
It may seem like the answer to the second question is obvious—you want it to eliminate your problem—but there’s actually more to it than that. You also want a surgery that will help you avoid a recurrence of the condition in the future, so you don’t need surgery again two, three, or five years down the line.
You also hope the procedure will preserve your natural range of motion, so you can continue to do all the things you love. (By now, you’re probably aware of the motion limitations associated with fusion surgery and want a better option.)
Be your own advocate! Find out more about surgical options for treating back and leg pain and the conditions those options are intended to treat.
So the surgery you do have should not only be appropriate for your condition, but it should also give you back the life you had before back or leg pain was an issue.
So what are your options for achieving these goals? Let’s take a look.
Motion-Preserving Spinal Surgery Options: Will They Address Your Condition?
There are three primary motion-preserving spinal surgery options. Each should be evaluated on whether they will adequately address your specific condition, and the likelihood of needing future surgery.
Artificial Disc Replacement
What problem does it address? An artificial disc replacement only works for patients with a degenerated or worn disc. During the procedure, a surgeon replaces the problematic disc with a new, artificial one, leaving the adjoining facet joints intact. (For more background information about disc replacement surgery read this article.)
Will it help you achieve your goals? Because your facet joints remain intact, this type of surgery will eliminate your pain if your only issue is the worn or degenerated disc. A very small percentage of patients (only 2 to 5 percent) actually fit that profile, however, which is why artificial disc replacement doesn’t work in most cases where patients have stenosis or leg pain. Even for those patients with just a degenerated disc, the facet joints may also be starting to wear down and become arthritic, which will cause pain down the road and potentially require additional surgery. But most importantly, for patients who suffer from pinched nerves as well as a worn disc, and this surgery will not unpinch the nerves.
Minimally Invasive Surgeries
What problems do they address? There are several minimally invasive surgery options that correct a variety of back problems. These generally fall under a larger category of what are called “decompression surgeries.” For instance, a foraminotomy addresses pinched nerves in the spinal canal, and a discectomy addresses a herniated disc by removing just a portion of the disc that is interfering with surrounding nerves.
Will these surgeries help you achieve your goals? Most patients prefer smaller procedures like these—so if a minimally invasive procedure will eliminate your problem and help avoid fusion, it may be a good option for you. Keep in mind, your pain may be caused by more than one problem—for instance, pinched nerves and a degenerated disc. If either is the case for you, you run the risk of needing surgery again in the near future if you move forward with a minimally invasive procedure. However, if instability is not an issue, these procedures can be a reasonable option.
What problem does it address? During the BalancedBack procedure, your surgeon implants a device that replaces the worn-out joint completely, including the function of the disc and facet joints. Because the procedure is performed using a posterior approach, your surgeons can directly address a number of other back and leg pain conditions (including pinched nerves from spinal stenosis, among others). BalancedBack is the only artificial disc replacement for patients with both leg and back pain, because BalancedBack is a Total Joint Replacement.
Will it help you achieve your goals? If your back problems go beyond what can be solved by artificial disc replacement or minimally invasive surgery, BalancedBack could be a good solution. It can address multiple root causes, improving your chances of living pain-free and reducing the likelihood of needing more surgery in the future. It also allows you to retain full, natural range of movement and sagittal balance.
If you’d like more in-depth information about why back and leg pain occurs; traditional surgeries and the conditions they are intended to treat; and BalancedBack Total Joint Replacement, visit our website.