Procedure of the Month

You Chose Selection #4:
Lumbar Artificial Disc Replacement

Though this is a treatment option, it is not the best treatment. Why? Firstly, the majority of her pain is radicular pain (90%) not mechanical back pain (10%). Since the majority of her symptoms appear to be originating from the S1 nerve root, a decompression is indicated, but there are no clear indications for disc arthroplasty. Secondly, if disc replacement surgery is considered, a discogram may be useful in evaluating the disc(s) as a pain generator. Thirdly, given her young age (26 years), disc replacement surgery should be delayed for as long as possible since the prosthesis is mechanical and is at risk for wear and eventual failure. Lastly, if she continues to have worsening back pain after decompression alone, she would still be a potential candidate for disc replacement if indicated.

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