The patient, who doesn’t want to be named, lives in the U.S. and has had several microsurgeries in the past and even flew to South America to try stem cell therapy but has continued to suffer disabling low back pain. The patient has a family history of spinal problems and a parent who has required several spinal fusion surgeries. The patient’s strong desire to avoid going down that same path has led the patient to research the benefits of motion-preserving lumbar disc replacement as an alternative to spinal fusion. The patient chose a disc replacement to treat their severe pain without limiting the motion of the back in the hope that this will prevent the need for future surgeries. After doing extensive research, the patient selected Dr. Good for his expertise in this technology, and furthermore his personal experience growing up with a father who suffered after failed spine fusion surgery. After initial telemedicine consultations across the country, the patient traveled to the Virginia Spine Institute on June 21, 2021, where he was diagnosed with spinal stenosis and spondylolisthesis with radiculopathy, and then prepared for a two-level lumbar disc replacement.
Traditionally this patient’s case would have been treated with a two-level spinal fusion surgery requiring spinal implants (screws and rods) to be placed in the back. This procedure involves fusion or “welding the bones together” which limits the motion of the low back. Because the patient has family members who have had failed spinal fusions and multiple surgeries, the patient preferred to avoid the stiffening of the spine and the decreased mobility caused by a spinal fusion.
“The patient is in phenomenal shape and used to lead a very active life, but as his pain worsened, he was unable to carry out the physically demanding aspects of his law enforcement career and was put on desk duty. He was also no longer able to play with his daughter or even carry out simple daily household tasks. It was very important to him that he get his personal and professional life back. He came to me desperately hoping there was another option and I was proud to be able to provide that,” explains Dr. Good, Spine Surgeon and President of Virginia Spine Institute in Reston, VA.
Speed was important to the patient, who traveled from out of state and needed to return to work as soon as possible so Dr. Good and his team put together a plan of care for a 2-level lumbar disc replacement and performed it days later (on June 25, 2021) at Reston Hospital Center. The procedure is designed to achieve pain relief by removing the painful discs while maintaining the natural motion of the spine. That’s done by inserting a device that closely mimics the natural movement of the healthy human spine.
Dr. Good used the activL® Artificial Disc with Intelligent Motion Technology, a third-generation lumbar disc replacement with a polyethylene core that allows for both translational and rotational movement and can be customized with a range of endplate configurations and construct heights. “Being able to offer a two-level lumbar disc replacement to a young healthy patient as an alternative to a spinal fusion offers significant benefits to that patient in the future both improving flexibility of the spine and hopefully also lowering the risk for additional spinal surgeries in the future,” explains Dr. Good, who predicts this active patient will return to a life with no pain or limitations.
Dr. Good has used this device for one and two-level disc replacement surgeries as well as hybrid procedures where an artificial disc is combined with a minimally invasive spinal fusion to treat two unhealthy discs. “Patients are much better off when we personalize and customize treatment based on their needs. The human body is meant to move and as surgeons, preserving that motion whenever we can is inherently beneficial. This is a significant development for our practice and demonstrates our continued commitment to providing innovative solutions for treating back pain,” said Dr. Good.
Groundbreaking technologies like artificial disc replacement allow for customized treatments for patients who are undergoing spine surgery and to offer much more advanced treatment options than have been available in the past. Artificial disc replacement offers the benefits of improving range of motion and flexibility after surgery and also potentially decreasing the risk for additional problems and surgeries in the future.