Alternativesto total disc replacement

There may be alternatives to total disc replacement, depending on your condition.

Most doctors recommend spine surgery as a last resort, that is, when back pain or referred pain has become chronic or after trauma. This is because although most people experience some improvements after surgery, there’s a risk of the surgery not being effective. For some people, spinal surgery has side effects and may even make the problem worse.

Your doctor may recommend surgery sooner if pain is severely limiting your activities or if you have neurological complications. However, for many people, back and neck problems (even ones with obvious mechanical causes, like a degenerated disc) improve without surgical treatment.

If you want to avoid or delay surgery on your disc, have a think about these non-surgical procedures and chat to your doctor.

Things you can do yourself

There are several things you can do to help relieve the symptoms of a damaged or degenerated disc. They include short rest, learning to do things differently so that you avoid pain, a program of exercise, losing weight, using a TENS machine, improving your mood, mindful meditation and using hot and cold packs. Complete bed rest is no longer recommended for most types of neck and back pain. Learn more about things you can do yourself.

Medications

While medications may relieve symptoms, they don’t address the actual cause. Some of them are only available on prescription from your doctor. Some can be used on a regular basis, while others are only suitable for short-term flare-ups. The main types of medication for back pain are painkillers, antispasmodics, antidepressants, and steroid injections. Medications for radiating arm and leg pain include the anti-epileptic medications such as pregabalin (Lyrica®) and gabapentin (Neurontin®). Learn more about medications.

Advice from the experts

Back and neck problems are so common and difficult to treat that medical professionals have developed several different ways of managing them.

Your GP can help you with medication, imaging and referrals to physiotherapists, occupational therapists, specialist doctors and surgeons.

Many people also seek independent advice from chiropractors, osteopaths, acupuncturists, massage therapists and psychologists. Learn more about how health professionals can help.

Non-surgical interventions

There are several non-surgical interventions (or less-invasive surgical interventions) that can help back symptoms, including a pain management program, neurotomy, a spinal cord stimulator, an intrathecal pain pump and more. Learn more about non-surgical interventions.

Spinal fusion

Spinal fusion is an older and more widely practised surgery compared to total spinal disc replacement. It’s usually done when disc replacement isn’t an option. This can be the case if you have instability in your spine, if your facet joints are significantly degenerated or painful or if you have osteoporosis.

Because this surgery fuses your spine, it can reduce your mobility. This could be a problem if you’re still relatively young and/or active.

Some studies show slightly better outcomes with disc replacement than with spinal fusion surgery, but the difference is minor and the risks are comparable. People are slightly more likely to say they’re satisfied with their surgery after disc replacement than after spinal fusion.

With spinal fusion surgery, a bone graft may be taken from your hip so the graft site can be a potential source of additional pain after surgery. Learn more about spinal fusion.

Microdiscectomy

If your problem is referred pain from a herniated disc, you may be a candidate for a less invasive
surgery called microdiscectomy. Learn more about microdiscectomy