Talkback, BackCare’s quarterly magazine, provides BackCare’s members with the latest information on back care and back pain related treatments, products and developments.
Articles from previous issues of Talkback can be found in our online database. You can search by treatment / therapy or by subject. You can also search by name, if you know the name of the author of the article you are looking for.
The ten most recent articles are listed below. For more articles, select a subject or therapy or search by author.
Wallis disc replacement
2009
Question
Having read many articles about the latest treatments for back pain ie Wallis disc replacement, X Stop, etc, I consulted a surgeon – who I no longer see – some time ago to ask if these treatments could help me but was told that disc degeneration at L5/SI could not be helped by these treatments as at this point of the spine there was nothing to attach them to. I was offered a fusion which on the advice of my GP turned down.
I would appreciate some advice as to whether there are any new treatments being investigated for treating this area of the spine. I know of many other people with disc degeneration at this point who like me are desperate for modern technology to help them. I have, of course, tried all conventional treatments such as physiotherapy, chiropractic, exercises, hydrotherapy, epidurals etc.
Mrs C D – Beds
Answer
Mrs D has written to us before about her back problem (ref Talkback Summer 2008) and wonders if any modern gadget will provide an easier cure. She has tried all the relatively straightforward and non-invasive remedies without any lasting benefit. She appears to be struggling with disabling back pain in her early sixties. I assume she is otherwise fit and potentially active. The source of the pain appears to be a worn out L5/S1 disc which is behaving like a flat tyre and letting her lowest lumbar vertebra (L5) slip forward a bit. This is creating a painful and mechanically unsatisfactory situation. The only remaining option appears to be surgery, although I have not seen her personally.
The pros and cons need to be discussed fully with her surgeon who will not be happy to operate unless Mrs D is determined to go ahead having understood what is involved. The final decision is hers alone. She will probably be in hospital for a week and need someone to do her cooking cleaning and shopping for a month or so before gradually starting to get out and about. It will be two to three months before she becomes independent and she will go on improving for a year or so provided she is determined.
There is a 10% chance of being worse and perhaps a 20% chance of not being much better, but these figures are a generalisation and do not necessarily apply to all.
The most important point about contemplating surgery apart from having a full understanding of what is involved before, during and after, is to have an experienced spinal surgeon who will explain his or her recommended operation, she must then work hard with the rehabilitation team to get the best result. It sounds as though fusion is probably going to be necessary at that level in the spine and modern instrumentation (gadgets/implants) may or may not help depending on the local anatomy. The fact that her GP has advised against fusion must be placed in the balance but all the other factors must be taken into account.
Good luck! Do let us know how things go.
Alan Gardner FRCS
Consultant Spinal Surgeon (Rtd)