Lumbar fusion Essay -- Health, Diseases, Back Pain

In 1993, Will, a 49-year-old pipeline welder started experiencing back pain. At first he believed the pain was due to normal muscle strain after working hard on the job, but many years later the pain still hadn't subsided, and had become increasingly worse. In 2002, Will was experiencing higher levels of pain in his lower back, and pain traveling down the back of his left leg. Over the course of a year this pain grew into a stabbing sensation in his thigh, that would come and go in electric shock like bursts. Will was having a difficut time working with sudden onsets of debilitating pain so he decided to take some time off from work and consult his doctor. Will's first examination by his primary care physician consisted of testing his flexibility and checking his back muscles for stiffness and spasms after performing load bearing exercises. Will's doctor found signs of a muscle strain, so he sent him home with a prescription of ibuprofen, and advised Will to take some time off work to rest. Taking things easy after two weeks off from work hadn't improved Will's condition, so he returned to see his doctor. X-rays were taken and the doctor discovered signs of arthritis in Will's spine. The doctor wasn't sure of his diagnosis, so he reffered Will to a spine therapy specialist to undergo physical therapy in hopes that the pain might be alleviated after strengthening the back muscles. If the back pain still didn't improve after taking these measures, an MRI (magnetic resonance imaging) of the lumbar area would be considered. Low back pain is the fifth most common reason for all physician visits in the United States, [1] so when doctors see patients with cases of chronic lower back pain like Will's, they typically suggest medicati... ...her important consideration is that artificial disc replacement surgery requires an anterior approach through the stomach, and can cause major damage to important blood vessels, intestines, and urinary system components. Will's herniated discs are located in the lower lumbar region, and these vertabae have a low degree of flexation compared to vertabrae higher up in the spine. This means that replacement discs won't aid that much in retaining mobility, and lumbar fusion won't reduce flexation by that high of a degree. The experience of the surgeon should also be taken into consideration, and few surgeons have adequate experience with total disc replacement at this time. These reasons lead me to believe that a lumbar fusion would be the safest surgery for Will, providing adequate pain relief, and wouldn't limit his range of motion enough to warrant replacement discs.