When 18-year-old Corey Hepker experienced a dirt bike incident that left his legs numb, he underwent a spinal fusion. Now in his early 30s, here's what he has to say about the experience... and where BalancedBack® comes in.
Recently, a patient in his late 30s visited my office. He had already had two discectomies in which portions of a disc were removed; now he was suffering from a large disc herniation again. His nerves were being pinched and causing leg pain, meaning even more of the disc would need to be removed to address the issue. At this point, the affected disc was worn out. His options for treatment were either artificial disc replacement (ADR) (also called total disc replacement), BalancedBack® Total Joint Replacement, or spinal fusion.
Many people in their 30s find themselves in a similar situation. If this sounds like you, here are some things to consider about artificial disc replacement, and a total joint replacement that could be a better option.
Total Disc Replacement In Your 30s: 3 Things To Consider
1. The Outcome
At any age, artificial disc replacement surgery will be successful only if the problem is isolated to the disc. If anything else is contributing to the pain—such as a pinched nerve or worn facet joints—a new disc solves only part of the problem. In ADR, the attached facet joints are left intact. They, too, will naturally degenerate over time, possibly even becoming arthritic and painful. If there’s any indication of early joint degeneration at the time of surgery, disc replacement surgery likely won’t prevent you from having back pain in the future. In addition, disc replacement surgery does not address the most common cause of back and leg pain, which is pinched nerves.
The fact is, only about 2 to 5% of patients have the right indications for total disc replacement; in other words, they’re the only ones who would benefit from this type of surgery at all.
BalancedBack® Total Joint Replacement replaces the function of both the facet joints and the damaged disc. That means it can not only alleviate the pain associated with a problematic disc, but it also allows surgeons to address back pain from arthritic facet joints. A total joint replacement can also relieve pinched nerves from spinal stenosis and other problems, making it a good option for more than 50% of potential patients.
2. The Potential Drawbacks
In artificial disc replacement surgery, surgeons use an anterior approach (from the front), which has some downsides.
First, surgeons have to work around vital internal structures—such as the bladder, kidneys, ureters, part of the colon, and some major blood vessels—to access the damaged disc, which makes the surgery somewhat risky. For that reason, anterior surgery carries a small risk of a sexual dysfunction called retrograde ejaculation in men, caused by cutting through small nerves in the belly to access the spine. Second, ADR leaves a scar on the abdomen, which could be a cosmetic concern for both men and women. Lastly, the recovery from anterior surgery is generally more difficult and painful compared to posterior surgery.
BalancedBack® Total Joint Replacement surgeons approach from the back (posterior) of your spine. There’s much less risk of damaging vital structures with this approach. During the procedure, a surgeon gently manipulates the nerves near the spine. While there is a chance of bruising, stretching, or other damage to the nerve with the posterior approach, it is small; in most instances, these issues will resolve on their own over time.
3. Future Surgery
It’s not clear how long a disc replacement will last, but, like all artificial implants, it will wear out over time. That means you may eventually need revision surgery. For an anterior disc replacement (total disc replacement), that means a second surgery through the abdomen. Scarring as a result of the initial surgery makes it difficult for even the most experienced surgeons to avoid injury to vital vessels and organs, and, as a result, anterior revision strategy can be quite challenging and potentially dangerous.
A BalancedBack® Total Joint Replacement may still require future revision. But because it uses a posterior approach, the revision strategy is much less challenging and certainly not as likely to cause a major problem.
The Recovery Phase: Total Disc Replacement Vs. BalancedBack®
For a patient in his or her 30s, the recovery phase for both types of surgery would look very similar. Most patients need to limit their activities in the first six weeks after surgery—no heavy lifting, pushing, or pulling. Somewhere between four and six weeks, they can start increasing their overall motion and gradually begin lifting things again. At three to four months, the implants used in both surgeries should be completely stable, requiring no further restrictions on activity.
Would you like to know if you’re a candidate for BalancedBack® Total Joint Replacement?
If you’re contemplating total disc replacement surgery (ADR) and would like to know if BalancedBack® could work for you, contact us. It isn’t right for everyone, but it is an exciting treatment option for many patients. Whether you’re 30 or 70, it could be just the solution you’ve been looking for to relieve your back and leg pain—and take back your life.