- With Mayo Clinic neurologist
Jerry W. Swanson, M.D.
read biographyclose windowBiography of
Jerry W. Swanson, M.D.
Jerry W. Swanson, M.D.
Dr. Jerry Swanson is a board-certified neurologist at Mayo Clinic and is a professor of neurology at Mayo Clinic College of Medicine. He has a special interest in headache disorders and medical education.
Dr. Swanson, a Lacon, Ill., native, was appointed to the Mayo Clinic staff in 1982 and works in the Department of Neurology with about 90 other physicians. He formerly chaired the Headache Division in the Neurology Department at Mayo Clinic and works with headache subspecialists around the world. He has published and lectured widely on headache disorders. He also serves as Assistant Dean for Assessment in Mayo Medical School.
"In a manner similar to the printing press, Internet technology enables the unprecedented ability to communicate with the global community about health information," Dr. Swanson says. "There is no doubt that the knowledgeable individual contributes greatly to his or her own health care, and now we can share information much more widely."
"There is much information already available about health care on the Internet. Unfortunately, much of it is not founded on sound principles. It is exciting to be a part of the MayoClinic.com team and contribute to the creation of a reliable and timely health resource."
Dr. Swanson is the neurology editor for "Mayo Clinic Family Health Book" and has reviewed articles for "Mayo Clinic Health Letter" and "Mayo Clinic Women's HealthSource." He is also editor-in-chief of the "Mayo Clinic on Headache" book, published in 2004. In 2008 the magazine "Women's Health" named him one of America's Top Doctors for Women.
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Question
Disk replacement: An effective treatment for low back pain?
Is disk replacement surgery an effective treatment for low back pain?
Answer
from Jerry W. Swanson, M.D.
The usefulness of disk replacement surgery in treating chronic low back pain is a topic of considerable debate.
Some research suggests that lumbar disk replacement may reduce back pain due to degenerative disk disease with fewer complications and a shorter recovery time than can other forms of back surgery, such as spinal fusion. However, more research is needed to evaluate the long-term safety and effectiveness of lumbar disk replacement.
Spinal fusion has long been considered the only surgical treatment option for low back pain caused by degenerative disk disease. In this procedure, the damaged disk is removed and the adjoining vertebrae are fused together by bone grafts and metal devices secured by screws. Although spinal fusion reduces pain, it results in some loss of flexibility in the spine. Recovery time can be significant.
Disk replacement is a relatively new treatment option for degenerative disk disease. In this procedure, the damaged disk is removed and replaced with a metal and plastic disk. As with all emerging treatments, the indications for its use are still limited.
Ideal candidates for disk replacement surgery:
- Are younger than age 60
- Have only one degenerated disk
- Are free of other bone diseases or deformities
- Have a healthy weight
- Have not had previous back surgery
- Have failed to respond to other forms of treatment
Disk replacement surgery isn't recommended for people who have systemic bone disease, such as osteoporosis, or those who've had previous back surgery, including spinal fusion.
If you're experiencing low back pain, remember that surgical treatment isn't the answer for most people. Work with your doctor to weigh the risks and benefits of all treatment options.
Next questionInversion therapy: Can it relieve back pain?
- Chou R. Subacute and chronic low back pain: Surgical treatment. http://www.uptodate.com/home/index.html. Accessed Sept. 15, 2008.
- Disk replacement. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00502. Accessed Sept. 15, 2008.
- Leahy M, et al. Comparison of results of total disc replacement in postdiscectomy patients versus patients with no previous lumbar surgery. Spine. 2008;33:1690.
- Fras CI, et al. Prevalence of lumbar total disc replacement candidates in a community-based spinal surgery practice. Journal of Spinal Disorders and Techniques. 2008;21:126.
- Zigler J, et al. Results of the prospective, randomized, multicenter Food and Drug Administration investigational device exemption study of the ProDisc-L total disc replacement versus circumferential fusion for the treatment of 1-level degenerative disc disease. Spine. 2007;32:1155.
