Alternative Treatment Options

Wallis® Dynamic Stabilization

This is an alternative means of off-loading the affected part of the spine and providing stabilization without resorting to a rigid fusion. Its aims are thus very similar and, although the technique has the advantages of lower risk and less invasive surgery, it is not quite so widely applicable.
(See Wallis® Stabilization)

Lumbar Disc Replacement

Disc replacement offers an alternative method of dealing with back pain arising from a disc which has become worn and damaged. The disc generating pain is completely cleared away. The artificial disc inserted in its place mimics a normal healthy disc, restoring normal movement at this part of the spine and avoiding the transfer of stress to other parts of the lower back. The height of the disc is returned to normal too, off-loading the facet joints and opening out the neural foramen on either side.
In some cases, for example where the disc is rather more damaged, disc replacement may be more appropriate than dynamic stabilization. Where the damage is less severe dynamic stabilization techniques offer less invasive surgery with a lower risk of complications.
(See Lumbar Disc Replacement)

Spinal Fusion

Fusion in this context means joining together with bone and spinal fusion joins together the vertebrae adjacent to painful degenerative discs and facet joints. This can be achieved in various ways but often will involve removing the degenerative structures and replacing them with bone graft. The aim is for this to form into a solid mass of bone that will eliminate any movement, which is often painful, between the vertebrae involved. To help hold things still and provide structural support while the fusion develops various forms of screws, rods and cages may be used.

Spinal fusion is a tried and tested technique and one which has evolved and improved, particularly over the past few years to give more reliable results with less risks and other problems than was the case in the past. Compared with dynamic stabilization there are certain drawbacks. The recovery and recuperation after spinal fusion is certainly slower and longer. The rigid immobilization of one part of the spine will transfer movement and stress to other levels which may then become troublesome in future years, a problem known as adjacent level disease. Bone graft is usually taken from the pelvis as this can cause ongoing discomfort. There are some risks associated with inserting screws, rods and cages and they can break or loosen at a later stage, particularly if a fusion does not develop, which happens in a proportion of cases. All of these problems can require further surgery.

Spinal fusion (or disc replacement) will often be the more appropriate option in those cases where dynamic stabilization could not be undertaken or may be inadvisable (see above).
(See Spinal Fusion)

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