It is estimated that around 10 percent of those who suffer from acute lower back pain need surgery when conservative treatments fail to yield results. While surgical interventions like removing the entire disc and replacing it with a bone graft have their limitations, a relatively new procedure -- Artificial Disc Replacement -- might be the answer for patients suffering from acute back pain.
Ekta Sahni, a 31-year-old Delhi housewife, was suffering from acute back pain for the last two years. She tried physiotherapy, acupuncture and other alternative healing methods but there was no respite. Finally, when doctors offered to replace her degenerated disc with an artificial one, Ekta agreed; she is feeling the difference within a week of the operation.
"My back condition was so bad that I was bedridden for around two months. I had tried everything. I am glad I underwent this operation and hope to carry on with my normal chores," she says.
"One of the major advantages of disc replacement is that it preserves the mobility of the patient's adjacent discs and delays the onset of arthritic changes adjacent to the operative level," says Dr Shankar Acharya, who operated on Ekta. Dr Acharya is the spine surgeon and consultant orthopaedic at New Delhi's Sir Ganga Ram Hospital.
Talking about fusion surgery, which is more popular in India, Dr Acharya says, "While fusion helps in controlling pain, it does not restore the patient's physiological motion. It also causes stiffness and decreases the spine's motion."
The ability of the bone to heal or 'fuse' also varies. The bone is generally taken from the hip of the patient, which requires a separate surgery.
Artificial disc replacement got a recent shot in the arm when the US Food and Drug Administration approved the SB CHARITE artificial disc that is used in India.
"It is still early days, but going by the response of the patients to the artificial disc, the procedure has been very successful," says Dr Sajan Hegde, consultant orthopaedic surgeon, Apollo Hospital, Chennai.
As far as the cost of the operation is concerned, doctors are almost unanimous that it would be almost the same as similar operations. An artificial disc comes for around Rs 65,000, plus the operation charges.
"Fusion surgery would almost cost as much. Due to the advantages of the artificial disc replacement, more and more people could undergo this operation," says Dr Hegde.
However, the new procedure is not without its share of limitations. Artificial discs cannot be implanted in patients who are too old and in people with weak spinal structures. Some other complications include infection and the possibility of a dislocation of the implant.
Currently, there are very few hospitals in the country that carry out artificial disc replacements. "Disc replacement is carried out in patients who have no other options. So this procedure will continue to be done on select patients," says Dr Acharya says.
With relatively young people like Ekta Sahni suffering from acute back pain, artificial disc replacement, even if done in select cases, comes as a ray of hope for those find back pain debilitating.
