Alternative Treatment Options

Lumbar Disc Replacement

Lumbar 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)

Dynamic Stabilization using screws and flexible rods

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 to Wallis® stabilization, but are achieved in a slightly different way. Screws are placed into the vertebrae and flexible rods are used to distract between these screws, reducing the loads through the disc and the facet joints and also providing stability.

This technique may well be applicable in some situations where the Wallis® stabilization cannot be used, for example if the spinous processes are defective or have been removed. The stabilization is comparatively stiffer and so it may be possible to use this technique in somewhat more advanced degenerative disease in which the use of the Wallis® technique would perhaps be unwise. Although less invasive techniques can still be used, the technique can be a little more damaging to the back muscles and carries with it the additional risks of placing screws into the vertebrae. Equally importantly there are some long term risks of the screws loosening or breaking because the movements of the spine continue to load the screws.
(See Dynamic Stabilization with Flexible Rods)

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 Wallis® 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 some 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 Wallis® stabilization could not be undertaken or is inadvisable (see above).
(See Spinal Fusion)

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