Disc degeneration: Current surgical options

C. Schizas, G. Kulik, V. Kosmopoulos

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Chronic low back pain attributed to lumbar disc degeneration poses a serious challenge to physicians. Surgery may be indicated in selected cases following failure of appropriate conservative treatment. For decades, the only surgical option has been spinal fusion, but its results have been inconsistent. Some prospective trials show superiority over usual conservative measures while others fail to demonstrate its advantages. In an effort to improve results of fusion and to decrease the incidence of adjacent segment degeneration, total disc replacement techniques have been introduced and studied extensively. Short-term results have shown superiority over some fusion techniques. Mid-term results however tend to show that this approach yields results equivalent to those of spinal fusion. Nucleus replacement has gained some popularity initially, but evidence on its efficacy is scarce. Dynamic stabilisation, a technique involving less rigid implants than in spinal fusion and performed without the need for bone grafting, represents another surgical option. Evidence again is lacking on its superiority over other surgical strategies and conservative measures. Insertion of interspinous devices posteriorly, aiming at redistributing loads and relieving pain, has been used as an adjunct to disc removal surgery for disc herniation. To date however, there is no clear evidence on their efficacy. Minimally invasive intradiscal thermocoagulation techniques have also been tried, but evidence of their effectiveness is questioned. Surgery using novel biological solutions may be the future of discogenic pain treatment. Collaboration between clinicians and basic scientists in this multidisciplinary field will undoubtedly shape the future of treating symptomatic disc degeneration.

Original languageEnglish
Pages (from-to)306-315
Number of pages10
JournalEuropean Cells and Materials
Volume20
DOIs
StatePublished - 1 Jan 2010

Fingerprint

Intervertebral Disc Degeneration
Spinal Fusion
Fusion reactions
Surgery
Total Disc Replacement
Pain
Electrocoagulation
Bone Transplantation
Low Back Pain
Physicians
Equipment and Supplies
Incidence
Bone
Stabilization
Therapeutics

Keywords

  • Degenerative disc disease
  • Dynamic stabilisation
  • Interspinous devices
  • Low back pain
  • Lumbar spine
  • Nucleous replacement
  • Spinal fusion
  • Surgery
  • Total disc arthroplasty

Cite this

Schizas, C. ; Kulik, G. ; Kosmopoulos, V. / Disc degeneration : Current surgical options. In: European Cells and Materials. 2010 ; Vol. 20. pp. 306-315.
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Schizas, C, Kulik, G & Kosmopoulos, V 2010, 'Disc degeneration: Current surgical options', European Cells and Materials, vol. 20, pp. 306-315. https://doi.org/10.22203/eCM.v020a25

Disc degeneration : Current surgical options. / Schizas, C.; Kulik, G.; Kosmopoulos, V.

In: European Cells and Materials, Vol. 20, 01.01.2010, p. 306-315.

Research output: Contribution to journalArticle

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