Canadian first in spine surgery at London Health Sciences Centre

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Everyone has back pain at some point in their life, some worse than others. People suffering from chronic back pain know just how much of a pain it can be. Just ask Mary Doyle whose chronic lower back pain impacted every part of her life as a wife, mother, and employee. Doyle, a 47-year-old bank teller from Ontario, says, “The pain was so bad that almost everything became a struggle. I couldn’t sit properly. I couldn’t sleep. Even basic household chores like washing the dishes came with pain.”

Chronic lower back pain is sometimes directly linked to accelerated disc degeneration to the point of causing debilitating pain. Discs are gel-like cushions that act as shock absorbers between each of the 24 bones in the spine. Over time, these discs can degenerate and lose their function, resulting in a great deal of pain for many people, like Doyle.

Standard treatment for lower back pain includes rest, medication, massage and physiotherapy. When these fail in improving symptoms, spinal fusion surgery is recommended. In spinal fusion, the movement of a degenerated disc is stopped by fusing the surrounding vertebrae together. However, with spinal fusion surgery there is no guarantee for pain relief, and a patient’s mobility can be limited.

Enter artificial disc replacement.

In April 2001, a surgical team, led by Dr. Kevin Gurr, Spine Surgeon, at London Health Sciences Centre (LHSC) in London, Ontario, completed the first artificial disc replacement in Canada on Mary Doyle.

Unlike traditional fusion surgery, artificial disc replacement actually replaces the bad disc with an artificial one. The result is the disc is restored to its original height, the spine is realigned, and there is less risk that adjoining discs will degenerate, as is sometimes the case with spinal fusion. For the patient, this cutting-edge surgery means new hope for pain relief, restored mobility, and a shorter recovery time.

The surgery changed everything for Doyle, who says, “As soon as I woke up from the operation, my pain was gone. I now have my life back, and I am living it to the fullest.”

According to Dr. Gurr, “Artificial disc replacement is as significant a development as artificial hip and knee replacements 30 years ago.”

At the same time, Dr. Gurr is quick to point out that, “This surgery is not going to be the solution for all back pain sufferers. It is for a select group of patients that has undergone extensive tests which clearly indicate that the chronic lower back pain is a direct result of a degenerated disc.”

The disc that is used in this new surgery is the LINK SB Charité Artificial Disc which has evolved a great deal from the time it was first developed in Europe a decade ago. It is made of polyethylene or “plastic” and slides between two metal end plates which attach to the vertebrae of the spine. The discs come in different sizes to fit a patient’s anatomy, and are designed to allow patients to replicate natural movement.

Artificial disc replacement surgery is also unique in its approach. Although it is back surgery, surgeons access the spine from the front through a small incision in the lower abdomen. The patient is discharged from the hospital three to four days after surgery.

Artificial disc replacement is only recommended after all traditional therapies have failed to provide pain relief, and only after extensive testing is completed. Part of the testing includes a Discogram, which is a diagnostic procedure aided by X-ray technology. It is one of the key indicators that a patient’s pain is directly caused by a disc that has degenerated in the lower spine. An artificial disc can only be used in one of the last two discs of the lumbar spine, L4-5 or L5-S1.

LHSC is the first Canadian hospital to have artificial disc replacement surgery. Dr. Kevin Gurr, along with Dr. Stewart Bailey, Spine Surgeon, has completed a total of ten artificial disc replacements, five male and five female patients with their average age being 41. So far, all ten patients are doing extremely well, with no failures in the disc, and 60 per cent of them are at the six-month mark of being pain free. In order for patients to find out if they are candidates for the surgery, they must contact their family doctor first for a referral to the Spine Centre at LHSC.