Last week in a post on X, owner of the platform Elon Musk really helpful people look into disc alternative in the event that they’re experiencing severe neck or back pain.
According to a biography of the billionaire, he’s had chronic back and neck pain since he tried to “judo throw” a 350-pound sumo wrestler in 2013 at a Japanese-themed party for his forty second birthday, and blew out a disc at the bottom of his neck.
In comments following the post, Musk said the surgery was a “gamechanger” and reduced his pain significantly.
Musk’s original post has to this point had greater than 50 million views and generated controversy. So what’s disc alternative surgery and what does the evidence tells us about its advantages and harms?
What’s involved in a disc alternative?
Disc alternative is a style of surgery by which a number of spinal discs (a cushion between the spine bones, also often called vertebrae) are removed and replaced with a man-made disc to retain movement between the vertebrae. Artificial discs are product of metal or a mix of metal and plastic.
Disc alternative could also be performed for plenty of reasonsincluding slipped discs within the neck, as appears to be the case for Musk.
Disc alternative is major surgery. It requires general anaesthesia and the operation often takes 2–4 hours. Most people stay in hospital for two–7 days. After surgery patients can walk but must avoid things like strenuous exercise and driving for 3–6 weeks. People could also be required to wear a neck collar (following neck surgery) or a back brace (following back surgery) for about 6 weeks.
Read more:
Elon Musk says ketamine can get you out of a ‘negative state of mind’. What does the research say?
Costs vary depending on whether you have got surgery in the general public or private health system, if you have got private medical insurance, and your level of coverage if you happen to do. In Australia, even when you have got medical insurance, a disc alternative surgery may leave you greater than A$12,000 out of pocket.
Disc alternative surgery isn’t performed as much as other spinal surgeries (for instance, spinal fusion) but its use is increasing.
In New South Wales for instance, rates of privately-funded disc alternative increased six-fold from 6.2 per million people in 2010–11 to 38.4 per million in 2019–20.
What are the advantages and harms?
People considering surgery will typically weigh that option against not having surgery. But there was little or no research comparing disc alternative surgery with non-surgical treatments.
Clinical trials are one of the best strategy to determine if a treatment is effective. You first want to indicate that a brand new treatment is best than doing nothing before you begin comparisons with other treatments. For surgical procedures, the subsequent step may be to check the procedure to non-surgical alternatives.
Unfortunately, these crucial first research steps have largely been skipped for disc alternative surgery for each neck and back pain. As a result, there’s an amazing deal of uncertainty concerning the treatment.
There are not any clinical trials we all know of investigating whether disc alternative is effective for neck pain in comparison with nothing or in comparison with non-surgical treatments.
For low back pain, the one clinical trial that has been conducted to our knowledge comparing disc alternative to a non-surgical alternative found disc alternative surgery was barely more practical than an intensive rehabilitation program after two years and eight years.
Yan Krukau/Pexels
Complications will not be unusual, and can include disclocation of the synthetic disc, fracture (break) of the synthetic disc, and infection.
In the clinical trial mentioned above, 26 of the 77 surgical patients had a complication inside two years of follow up, including one one who underwent revision surgery that damaged an artery resulting in a leg needing to be amputated. Revision surgery means a re-do to the first surgery if something needs fixing.
Are there effective alternatives?
The very first thing to think about is whether or not you would like surgery. Seeking a second opinion may assist you feel more informed about your options.
Many surgeons see disc alternative as an alternative choice to spinal fusion, and this selection is often presented to patients. Indeed, the research evidence used to support disc alternative mainly comes from studies that compare disc alternative to spinal fusion. These studies show individuals with neck pain may get well and return to work faster after disc alternative in comparison with spinal fusion and that individuals with back pain may get barely higher pain relief with disc alternative than with spinal fusion.
However, spinal fusion is similarly not well supported by evidence comparing it to non-surgical alternatives and, like disc alternative, it’s also expensive and related to considerable risks of harm.
Fortunately for patients, there are recent, non-surgical treatments for neck and back pain that evidence is showing are effective – and are far cheaper than surgery. These include treatments that address each physical and psychological aspects that contribute to an individual’s pain, equivalent to cognitive functional therapy.
Read more:
Surgery won’t fix my chronic back pain, so what is going to?
While Musk reported immediate consequence with disc alternative surgery, given the evidence – or lack thereof – we advise caution when considering this surgery. And if you happen to’re presented with the selection between disc alternative and spinal fusion, you may want to think about a 3rd alternative: not having surgery in any respect.