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Overview

Chances are you've had back pain at some point in your life—eight out of 10 people do. While back pain has many causes, one of the most common is degenerative disk disease, an erosion of the vertebral disks in the cervical (upper) and lumbar (lower) spine that is especially common as we age. 

The pain this causes can be incapacitating and quite disabling,” according to Yale Medicine Orthopaedics & Rehabilitation specialists, who have a long and highly respected track record in artificial disk replacement.

What is degenerative disk disease?

Not actually an illness or even an injury, the term “degenerative disk disease” describes damage to the spinal disks that serve as shock absorbers in the upper (cervical) spine, including the neck, and the lower (lumbar) spine and lower back. Many patients have severe back pain that makes it impossible to do simple things, like go to work or interact with their families.

What causes degenerative disk disease?

More often than not, degenerative disk disease occurs with no apparent cause, but a number of factors raise the odds that a person will experience this type of back pain. These include family history, injury and lifestyle (including smoking, unhealthy diet, lack of exercise and being overweight or obese). Age is also a factor. ranging While most patients with degenerative disk disease are in their 40s, the problem can affect people ranging in age from 18 to 60 and older.

What are the symptoms of degenerative disk disease?

Symptoms that indicate degenerative disk disease vary depending on the location of the damaged disk. For cervical disks, the pain can be felt in the neck. But the predominant symptoms are often felt in the arm, in the form of pain, numbness or tingling. Lumbar disk problems cause back pain and sometimes pain in the legs as well.

How is degenerative disk disease diagnosed?

In addition to a patient’s description of symptoms, diagnosis is made on the basis of a clinical exam that identifies areas that are tender or painful. Imaging studies such as magnetic resonance imaging (MRI) are used to pinpoint the location and extent of the damage.

How is degenerative disk disease treated?

When patients are diagnosed with degenerative disk disease, it is important first to try conservative (nonsurgical) treatment approaches. Those may include lifestyle changes, such as physical activity and weight loss, along with such treatments as:

  • Medications, including anti-inflammatories and pain medications
  • Physical therapy
  • Steroids, orally or via an epidural injection

If none of those treatments helps and the pain continues (six months for lumbar; three months for cervical), surgery may be an option. Spinal fusion (where several vertebrae are fused together) used to be the only treatment we could offer, and for some patients, it’s still the best option. But now, for some people, artificial disk replacement is a less invasive and more restorative procedure that allows them to once again begin to function normally.

What is artificial disk replacement?

While the patient is under general anesthesia, the orthopaedic surgeon first removes the worn and damaged disk and then replaces it with a mechanical one. The device is designed to move with the spine in a way that restores range of motion so the patient can once again move normally and without pain.

Disk replacements can be performed in the cervical and lumbar spine and, if necessary, several replacements can be done in one operative procedure. Depending on which disk or disks are being replaced, the procedure can be done on an outpatient basis or can require one or two nights in the hospital. Recovery typically takes two to six weeks, and most patients are able to do just about everything they did before the onset of back pain.

Medical research shows many advantages for patients who have disk replacement instead of spinal fusion. Because the procedure involves a minimally invasive approach, people have a shorter hospitalization, and they recover quickly, and get back to work and activities faster. This compares favorably to spinal fusion, which involves a recovery period of three to six months and also leaves the patient stiff and unable to move naturally.

Numerous research papers have shown that spinal fusion affects the disks above and below where the fusion was done, so the expectation is that a person who has had a spinal fusion will need more surgery down the road. Research shows that disk replacement decreases the likelihood of problems with other disks, so there’s less chance of needing another operation in the future.

What makes Yale Medicine’s approach to artificial disk replacement unique?

In addition to contributing to the technology used for artificial disk replacement, Yale Medicine has more years of experience treating patients with artificial disk replacements than any other institution in the area.