Lumbar Disk Replacement with Dr. Kimball

Treating patients with neck and back problems without the use of fusion involves replacing or fixing a disk that has been damaged rather than fusing it to another segment. Disk replacement can be done in the neck and in the lumbar spine.

Patients that have degenerative conditions of the spine, neck or back typically present with neck or back pain. Sometimes they will have symptoms of arm or leg pain too. Patients that have these symptoms may not require surgery and oftentimes their symptoms will get better without it, but it is part of the treatment process when all other non-surgical options fail.

When someone presents with neck or back pain, sciatica or radiculopathy symptoms (for example, sharp pain in the back radiating to the foot, or numbness/weakness in the leg and foot), they can be treated with non-surgical options. These include physical therapy, chiropractic, anti-inflammatory medication or injections around the spine or near the nerves that can help calm down the irritated part of the spine. These not only often relieve pain, but also help to identify where the problem area in the spine is. If these non-surgical options fail, there are indications when surgery is appropriate.

The surgical treatment sometimes involves just decompressing a nerve or taking some sort of arthritis or disk bulge or herniation off of a nerve and relieving the pain in that extremity. If there is pain in the back or in the neck, oftentimes it may involve a disk that has failed or degenerated and is causing that pain.

Not everybody is a candidate for disk disease surgery. Other surgical options include fusion, which means removing the disk, placing a bone graft and then putting in rods and screws. This can be a challenging process not only during the surgery, but also for the recovery and the long-term outlook of the rest of the spine after that surgery.

When someone shows up with back pain, they're looking for solutions and not always thinking about how the surgery is going to affect them two, five or ten years down the road. I want to offer a solution that not only takes care of the problem today, but is also thinking ahead.

When a segment of the spine is fused, the biomechanics of the spine are altered. The motion forces change, as they do where the stress itself has happened, so ultimately there is a shift in motion that was occurring at those segments that were fixed to the nearby segments. This can cause them to degenerate a little more quickly, which sometimes leads to even more fusion surgery down the road. My goal is to prevent that process.

Studies show that disk replacement reduces the risk of more surgery. This can be up to four to six times in the neck compared to fusion. In the lumbar spine, a patient can be up to three times less likely to have more surgery when indicated.

The recovery process after disk replacement surgery in the spine can actually be pretty fast; much faster than fusion. If fusion or disk replacement surgery can be avoided completely by conducting some sort of decompression of a nerve, that can be even faster. Minimally invasive surgery to remove pressure on a nerve is a same day procedure and not only do patients go home the same day, but they often feel better immediately. This does not mean they may not have some neck or back pain over the ensuing weeks as tissues are healing, but patients usually get back to a normal level of functioning by four to six weeks, depending on job requirements, daily demands and physical activities.

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