"CF," a 44-year-old woman from La Union province, had suffered chronic lower back pain since 1993. Her back pain was so severe that she could hardly walk and was bed-ridden for extended periods of time.
"There were days when I couldn’t sleep well because I was unable to find a position that would help relieve me of my pain," she said. "Sometimes, the pain was so great that I was forced to stay home and this really affected my job at the provincial government."
According to Dr. Ver, "CF" had exhausted all the treatments available for her condition.
There are two types of back pains – sciatic type and the discogenic type.
A pinched nerve is usually the cause of the sciatic type of back pain. There is severe pain in the lower back and down the back of the thigh and leg along the route traveled by the sciatic nerve.
This can be corrected through a laminotomy or laminectomy.
Most patients are able to recover after this procedure.
The discogenic type of back pain, however, is more difficult to cure. The source of the pain is the disc, which has developed cracks leading to the absence of water in the middle of the disc.
"The middle of the disc is made up of water and when there is a crack in the disc, the water is let out and this causes the pain in patients," Dr. Ver said. "Since the disc has no blood supply in adults, it cannot heal itself and the pain will continue to be there."
Since the usual practice is for back pain to be treated conservatively, CF was given medicines like oral analgesics to deal with the pain. She also underwent a series of physical therapy and has even been administered epidural steroid injections, but to no avail.
Another procedure that CF could have undergone is the spinal fusion surgery where one or more of the vertebrae of the spine are united together or fused so that motion no longer occurs between that.
The concept of fusion is similar to that of welding in the industry. Spinal fusion surgery, however, does not weld the vertebrae during surgery. Rather, bone grafts are placed around the spine during surgery. The body then heals the grafts over several months – similar to healing a fracture – which joins or welds the vertebrae together.
Last year, "CF" was diagnosed to have Degenerative Disc Disease (DDD). Degenerative changes in the spine accompanied by pain are some of the most common diseases of modern civilization. This degeneration can be the result of the natural aging process, an injury to the spinal disc or other related factors.
Back in 1987, the artificial disc replacement surgery was introduced in East Germany. This procedure, however, was only given approval by the United States Food and Drug Administration last year.
Spine arthroplasty or total disc replacement is a promising alternative treatment for DDD. By replacing the degenerated intervertebral disc with an artificial disc prosthesis, stability can be restored and the mobility of the motion segment is also maintained.
"CF" agreed almost immediately to be the first patient to undergo the procedure in the country.
It was developed at the Orthopedic University Clinic of Berlin Charité in Germany. The disc consists of two metal endplates made of high quality cobalt chromium alloy – an implant material which has been proven to be extremely well-tolerated by the body.
"Studies have shown that patients who undergo this procedure recover very quickly," Dr. Ver said. "In fact, patients are encouraged to get up and walk as soon as possible and this is usually a few hours after surgery."
This is what happened to "CF" who was up and about hours after the operation. She was in fact discharged three days after surgery. A week later, she could go up and down the stairs without any difficulty. She can even bend painlessly and with much ease.
"I can now walk properly and I do not experience the pain I was so used to. The surgery was a success if you ask me because the pain is all gone and I will be able to resume my regular activities," she said.
