Herniated Discs: New Treatment Option Relieves Pain, Preserves Mobility

Posted by Brigham and Women's Hospital July 19, 2016

ProDisc_ProDiscC_main_03

In artificial disc replacement (ADR), the damaged disc is removed and replaced with an artificial one that moves and shifts like a real disc.

Contributor: John H. Chi, MD, MPH, Director of Neurosurgical Spine Cancer and a spine surgeon in the Department of Neurosurgery at Brigham and Women’s Hospital. Dr. Chi is also an Assistant Professor of Neurosurgery at Harvard Medical School.

If you are experiencing numbness and pain in your arms and shoulder, it may be a sign of a herniated disc in your neck (the cervical region of the spine).

“A herniated disc occurs when the soft inner gel that cushions the spine’s vertebrae protrudes into the spinal canal, placing pressure on nearby nerves. This pressure can lead to pain, tingling, numbness or weakness in the shoulders and arms,” says Dr. Chi.

A herniated cervical disc may be managed with medication, physical therapy, and pain management. When patients continue to experience symptoms, surgery may be recommended .

Balancing Pain Relief versus Mobility

Until recently, patients requiring surgery for cervical disc herniation had one option, anterior cervical disc fusion (ACDF), in which the damaged disc is removed and repaired to help relieve pressure on the nerves and the spinal cord. The ACDF procedure also requires the bones above and below the repaired disc to be fused together.

Though ACDF relieves the pain caused by a herniated cervical disc, some patients may experience a reduction in their range of motion due to the fusion of discs in the neck. Furthermore, there is a chance that discs adjacent to the fusion may later herniate, requiring a second surgery.

 Artificial Disc Replacement to Preserve Range of Motion

Today, spine surgeons can offer certain patients with cervical disc herniation another option – artificial disc replacement (ADR). During the ADR procedure, the damaged disc is removed and replaced with an artificial one that moves and shifts like a real disc, preserving a patient’s range of motion.

Recently, Dr. Chi performed an ADR procedure on a patient who had previously undergone disc fusion (ACDF). Though the disc fusion initially relieved the patient’s pain, a disc adjacent to the fusion also herniated. The patient started experiencing significant pain again. This time, the patient opted to undergo ADR. Compared to his first surgery, Dr. Chi’s patient had a shorter hospital stay, a faster recovery, and maintained his full range of motion while finding relief from his chronic pain.

Are You a Candidate for Artificial Disc Replacement?

Artificial disc replacement is not for everyone. You may be a candidate for ADR if you are younger than 55 years and have been experiencing symptoms for at least three months but not longer than 18 months.

It’s not known how long artificial discs will last; however, they have been in worldwide use for almost 20 years and for 12 years in the U.S. So far, there has been no evidence to suggest that artificial discs will require replacement after a certain period of time.  Research also indicates that ADRs may lead to better outcomes than fusion.  Dr. Chi advises checking with your insurer to verify coverage if you are considering ADR.

Learn more about the Comprehensive Spine Center at Brigham and Women’s Hospital.

-Jamie R.

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Countdown to the New Year – Top Ten Posts for 2014

Posted by Brigham and Women's Hospital December 31, 2014

The blog team at Brigham and Women’s Hospital (BWH) is counting down to the New Year by revisiting our top 10 blog posts published in 2014, beginning with number ten. We’d also love to hear from you – what were your favorites? Thank you for your comments, questions, and continued interest in HealthHub. We wish you a healthy and happy New Year.

#10 – Video – Comprehensive Spine Care

Certain spinal conditions, such as back pain, are very common. However, treating these conditions can require the expertise and coordination of more than one medical specialty. Often, the first step is conservative, non-operative treatment by physiatrists, pain management physicians, and other specialists. Learn how our surgical and non-surgical spine specialists collaborate on care for patients with spinal disorders.

#9 – Improving Joint Replacement:  Consultation through Recovery

Based on the work of the Care Improvement Team, led by orthopedic surgeon Dr. John Wright, Brigham and Women’s Hospital uses a standardized approach to total knee replacement that guides how patients should be treated, from the time they arrive at the hospital for a consultation to the care they receive after discharge. This process has improved patient outcomes.

#8 – Colorectal Cancer: Do Men and Women Have Different Symptoms

Risk factors for colorectal cancer — which include age, family history of the disease, or having Crohn’s disease or ulcerative colitis — are similar for men and women. However, lifestyle choices that may impact the risk can differ between men and women. These include obesity, lack of physical activity, low vitamin D, and consuming a high amount of red meat.

 

#7 – Should You Go without Gluten?

Many people are becoming increasingly concerned about eating foods containing gluten. Gluten is responsible for the reaction that damages the lining of the small intestine in celiac disease. It also has been linked to less serious gastrointestinal complaints, such as diarrhea and bloating. Read more about how gluten can affect your health and the benefits of avoiding it.

 

#6 – Keys to Preventing Lyme Disease

Dr. Nancy Shadick, a rheumatologist at Brigham and Women’s Hospital (BWH), and her team have developed entertaining, interactive programs to increase people’s knowledge about Lyme disease, the consequences of the disease, and prevention techniques. Play the game to learn how you can prevent Lyme disease, a tick-borne infection that can cause neurological and joint problems.

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Comprehensive Spine Care: Surgical and Non-Surgical Treatment

Posted by Brigham and Women's Hospital May 6, 2014

Treating back pain can be very challenging, requiring the expertise and coordination of more than one medical specialty.

Certain spinal conditions, such as back pain, are very common. However, treating these conditions can be very challenging, requiring the expertise and coordination of more than one medical specialty, including physical medicine, pain management, and surgery.

“Back pain is a very common complaint, but a very non-specific complaint. Back pain and leg pain can be caused by many different things, including spinal stenosis, disk herniations, and instability. The procedures that we offer are really tailored to the specific patient with a specific disorder, based on imaging and exam,” says orthopedic surgeon Dr. Chrisotopher Bono, Co-Director, Brigham and Women’s Comprehensive Spine Center.

To ensure the correct diagnosis and treatment for spinal disorders, patients who are referred to the Brigham and Women’s Comprehensive Spine Center are evaluated with state-of-the-art diagnostic procedures and imaging. Often, the first step is conservative, non-operative treatment by physiatrists, pain management physicians, and other specialists.

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Spine Surgery: When Nothing Else Will Do

Posted by Brigham and Women's Hospital February 11, 2014

Cervical spine surgery patient - Diane Daigneau

Diane is back to work and play after cervical spine surgery.

For many years, Diane Daigneau of Woburn, MA, was able to successfully manage her back and neck pain. Through occasional chiropractic treatments and mild pain relief medications, she was able to continue to work and play.

A few years ago, however, she discovered that circumstances can change dramatically, to the point where even the best non-surgical care fails to provide adequate relief. Such was the case during the summer of 2013, when the pain radiating through Diane’s back, neck, and arms had become so debilitating and persistent that no physician was recommending anything other than cervical spine (neck) surgery.

From Manageable to Intolerable

Diane likes making things pretty. More than that, it’s her job.

She often spends several hours hovering over a single piece of furniture while meticulously applying delicate gold or silver leafing, or some other type of elegant exterior. It’s a mentally and physically demanding job, particularly for someone who has struggled with back and neck pain. But Diane’s pain was never so bad that she ever worried about not being able to do her job or any other enjoyable pursuits. That changed suddenly during a family vacation at the end of July 2013.

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Ringing out 2012 – Most Popular HealthHub Posts

Posted by Brigham and Women's Hospital January 1, 2013

The blog team at Brigham and Women’s Hospital would like to close out 2012 with a selection of our most popular posts.  We’d also love to read about your favorites in our comments section.

We wish you a safe and happy New Year and look forward to sharing more health stories with you in 2013.

 

1.  What’s in a Face?

After suffering a disfiguring injury, Dallas Wiens receives the gift of a new face – the first full face transplant in the U.S. – at Brigham and Women’s Hospital.  The life-giving surgery, performed by a team of more than 30 physicians, nurses, anesthesiologists, and residents , provides Wiens with the typical facial features and function of any other man.

 

2.  Prostate Cancer Screening – Should I or Shouldn’t I?

Dr. Anthony D’Amico, Professor and Chief of Genitourinary Radiation Oncology at Brigham and Women’s Hospital and Chief of the Prostate Cancer Radiation Oncology Service at Dana-Farber/Brigham and Women’s Cancer Center, discusses the benefits of prostate cancer screening, particularly for younger men.

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Spine Surgery — When Is It Right for You?

Posted by Blog Administrator May 16, 2012

 

spine specialist with patient

Dr. Bono (right) and his spine surgeon team strive to ease back pain with the least amount of surgery possible.

Dr. Christopher Bono, Chief of the Department of Orthopedic Surgery’s Spine Service, has a habit of talking patients out of spine surgery. It’s not that he doesn’t want to help you – quite the contrary.

Spine surgeons in Dr. Bono’s practice end up performing surgery on less than 25 percent of the more than 800 patients that they see each year. Dr. Bono is proud of that low rate, as his team’s goal, as ironic as it may seem, is to perform the least amount of surgery possible. His rationales for this objective are that spine surgery, even in the hands of its best surgeons, is a very risky proposition, and the vast majority of patients with back pain can be treated effectively without surgery.

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