Degenerative (wear-related) diseases of the lumbar spine are becoming increasingly common. On the one hand, they occur as part of a natural aging process, but can also be caused by trauma or be promoted by factors such as long working hours at the computer, overweight and lack of exercise. Such degeneration of the intervertebral discs (the cartilaginous parts between the 5 lumbar vertebrae) can lead to pronounced discomfort, including pain and numbness in the back, which can radiate to the hips and sometimes even to the legs.
As this severely restricts the quality of life of those affected, they often consult a doctor with the request for rapid assistance. The first step is usually to try a conservative therapy, but this often does not have a satisfactory effect. While in such cases in the past a stiffening of the spine (spondylodesis) was usually recommended, today there is a tendency to use a disc prosthesis.
Compared to surgical stiffening of the spine, the insertion of a disc prosthesis is the safer procedure for the patient. In order to protect the spinal cord, the surgical approach in a disc prosthesis operation is to make a 5 to 8 cm long skin incision in the lower abdomen. The procedure usually takes about 1 to 2 hours and is performed under general anesthesia.
The desired disc is first removed through the incision (discectomy). The space that has now become free is filled by an implant, the disc prosthesis. This prosthesis usually consists of two metal plates, between which a layer of plastic is placed.
This serves to ensure that the implant can, on the one hand, grow well and firmly into the surrounding structures and, on the other hand, can withstand the extensive movements in the area of the lumbar spine. Since the thickness of the prosthesis is adapted to the thickness of the intervertebral disc and has a certain deformability, the mobility of the lower back after the operation should finally be almost as natural as before the disease. If everything goes without complications, the patient can usually leave the hospital the second day after the operation.
First of all, he will have to wear a soft bandage (for about 6 weeks) in order not to endanger the healing process. By the end of this period at the latest, everything should have healed well and the patient can return to his or her normal everyday and professional life, although this is often possible while the bandage is still on. If possible, you should only wait a little longer before engaging in particularly strenuous sports; cycling or swimming, on the other hand, is not a problem.
In order to ensure an optimal course, it is advisable to integrate physiotherapy into the long-term treatment. The insertion of a disc prosthesis for symptomatic diseases of the lumbar spine has been considered the treatment of choice for some years now, as it is associated with a very high success rate (approximately 90%) and has a very low risk of complications. Advantages over other possible procedures are also the preservation of the natural range of motion of the lumbar spine and especially the rapid rehabilitation through the option of direct mobilization.
