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Lower back pain due to L4/l5 disc. Want doctor in Queensland to perform MISS disc replacement

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Spine Surgeon
Practicing since : 2002
Answered : 322 Questions
I have extremely bad back pain on my lower lumber for over 10 years. I have been told by my specialist Dr that my L4/L5 disc is the cause. I have recently watched on TV, a doctor in Sydney performed MISS (minimal invasive) on a patient and replaced her disc with a artificial one. Do you know any one in Queensland who does MISS disc replacement? It will be great if you could assist. Thanking you in advance. XXXXXXX
Posted Sun, 25 Aug 2013 in Back Pain
Answered by Dr. Rahul D Chaudhari 2 hours later
Thanks for writing to us.
Disc replacement surgery is meant for the patients who have disc disease and facet joints are normal. It is usually indicated in younger individual. In your case we need to see if you have any stenosis component and whats the status of facet joints. I think minimally invasive spinal fusion is a better option in your case.
Any way this is just to give you the information about the better option. However I dont know any one in your area as I am from different country. Thanks.
Above answer was peer-reviewed by
Follow-up: Lower back pain due to L4/l5 disc. Want doctor in Queensland to perform MISS disc replacement 31 minutes later

Thank you Dr Chaudari for your opinion. I think I know what you mean
However my MRI report states that:
L4/5 - there is marked disc height loss and disc desiccation.
There is anterior disc protrusion paracentrally.
There is end plate oedema and oedema within the anterior disc.
There is also mild broad based disc bulge posteriorly. This minimally narrows the central canal.
The neural foramina are patent.
There is moderate facet joint arthropathy.
Would you still think my conditions need MIS fusion rather than MIS Total Disc Replacement?

Answered by Dr. Rahul D Chaudhari 7 hours later
You have very valid question.
Purpose of the disc replacement surgery is to remove the painful disc and restore the disc motion with new artificial disc. Patient is a candidate only if the disc is dessicated and painful and rest spine normal (especially facet joints, also minimal disc height loss).
In your case if we opt for disc replacement then we have to remove the disc and to XXXXXXX up to restore the disc height so as to put the implant however that will distract the facet joints and may give rise to more pain on motion. Other important aspect, to put the implant, the end plates should be normal and healthy otherwise you land up with end plate fracture or settling of the implant into the weak end plate.
Now you are 71 and the reduced disc height shows that the severe degenerative changes are there and you are in auto stabilisation phase of the body healing ( based on no motion no pain principle). So by fusing the level you will help to stabilise that level and that will take away the pain.
If you go into literature you will hardly find any old patient having disc replacement due to above reasons.
I would strongly recommend to consider fusion rather than disc replacement. Thanks.
Above answer was peer-reviewed by
Follow-up: Lower back pain due to L4/l5 disc. Want doctor in Queensland to perform MISS disc replacement 19 hours later
Thank you for your detailed explanation of my options.
At the end of the day, I think I agree with you regarding the condition of my spine after over 70 years of continuous usage, I have to accept that it is not young and strong anymore. Fusion does seem a better option for me, so I will look for an experienced orthopedic in Brisbane. Thank you so much again for your help.
Kind regards XXXXXXX
Answered by Dr. Rahul D Chaudhari 4 hours later
Let me know if you have any queries. Thanks.
Above answer was peer-reviewed by
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