Out-of-state? Free MRI review + telehealth consult before you travel4.9 ★ · 619 Google reviewsBoard-certified — American Board of Orthopaedic SurgeryMinimally invasive, same-day spine surgery in Beverly HillsCall (424) 217-7463
Out-of-state? Free MRI review + telehealth consult before you travel4.9 ★ · 619 Google reviewsBoard-certified — American Board of Orthopaedic SurgeryMinimally invasive, same-day spine surgery in Beverly HillsCall (424) 217-7463
When a disc wears down, it can lose height, inflame the surrounding structures, and become a genuine source of back pain. Degenerative disc surgery addresses that worn disc directly — but only after imaging and your symptoms confirm it is truly the pain generator, and only after conservative care and injections have had a fair trial.
There is no single operation for a degenerated disc. Dr. Melamed matches the procedure to the case, favoring the least-invasive option that will do the job. For the right patient that may mean a motion-preserving disc replacement; for others, where instability or collapse is present, a fusion is the sounder choice. The starting point is always the same: confirm the source, exhaust conservative options, then choose the smallest procedure that solves the problem.
Surgery becomes a reasonable conversation when a specific worn disc is confirmed as the pain source, the pain is meaningfully limiting your life, and rest, therapy, and injections have not settled it. It is not for diffuse back pain without a clear generator, or for people who have not yet exhausted conservative care. Dr. Melamed reviews your imaging, your history, and your goals before recommending whether — and which — surgery fits.
Patients who have not found pain relief through conservative (nonsurgical) care and have suffered a diminution in their quality of life and ability to function because of a symptomatic degenerated disc should educate themselves and discuss the benefits and risks of each type of surgery with their physician.
How Surgery Treats a Degenerated Disc
The worn disc is removed and the space it occupied is addressed in a way suited to your anatomy. Where motion can be safely preserved, an artificial disc maintains movement at that level. Where the segment is unstable or collapsed, a spacer restores height and the level is fused so it heals solid. In both cases, any nerve compression caused by the disc is relieved at the same time.
Dr. Melamed reaches the disc through the least-disruptive route the case allows, using minimally invasive, muscle-sparing technique where suitable so that healthy tissue is spared and recovery is smoother.
Watch Dr. Melamed explain
Watch Before Agreeing to a Spinal Fusion, Artificial Disc, or Laminectomy · Dr. Hooman Melamed on YouTube
Recovery After Degenerative Disc Surgery
Recovery depends on which procedure was the right fit. Motion-preserving options often allow a quicker return to activity, while a fusion heals more gradually over weeks to months as the bone knits. In either case Dr. Melamed emphasizes early guided movement, muscle preservation, and a rehabilitation plan designed to limit reliance on narcotics.
Benefits of Degenerative Disc Disease Surgery
✓Targets a disc confirmed as the actual pain source
✓Least-invasive option chosen first
✓Motion-preserving disc replacement where suitable
✓Relieves disc-related nerve compression
✓Muscle-sparing technique where the case allows
✓Procedure matched to your specific anatomy
In addition to possibly improving one’s quality of life, there are some benefits to surgery:
Once the disc has been identified as the source of pain, surgery directly treats that source by removing the degenerated disc. Non-surgical interventions focus on managing the pain and improving back functionality but do not reverse the pathologic process of disc degeneration.
Surgical techniques and devices continue to evolve so that the outcomes of procedures improve. Less invasive fusion techniques, artificial discs, newer bone harvesting techniques, and bone graft substitutes constitute real breakthroughs that expand surgical options for patients.
There are two main types of surgery used to treat pain and symptoms from lumbar degenerated discs: lumbar fusion surgery and artificial disc replacement.
Lumbar Fusion Surgery
Lumbar fusion is designed to stabilize or stop the motion of the vertebral segment where the degenerated disc is located. The operation involves accessing the segment through a back and/or stomach incision (both of which require moving muscles and ligaments) and typically inserting hardware (such as pedicle screws) along with an interbody cage, spacers, or structural bone graft to temporarily immobilize the affected segment while the fusion is healing.
Artificial Disc Replacement Surgery
Artificial disc replacement, sometimes called total disc replacement (TDR), is a newer and somewhat more complex procedure than fusion.
Artificial disc replacement surgery involves the following steps:
Accessing the affected vertebral segment by making an incision in the lower abdominal wall;
Dissecting behind the “six-pack” muscles;
Working behind the bag of abdominal contents without disturbing them;
Removing the degenerated disc;
Restoring the height of the collapsed disc;
Remobilizing the segment by releasing the contracted ligaments around the disc;
And inserting an artificial disc in the correct position.
This type of surgery has been available in some countries for a number of years, and in the US, one technology was made generally available in 2004.
Conditions Treated With Degenerative Disc Surgery
Painful degenerative disc disease
A collapsed or worn disc confirmed as the pain generator
Disc degeneration with nerve compression
Disc-driven pain that has failed conservative care and injections
American Academy of Orthopaedic Surgeons (OrthoInfo), “Spinal Fusion”
Questions, Answered
Questions About Degenerative Disc Disease Surgery
How do you know the disc is really causing my pain?
Dr. Melamed correlates your imaging with your symptoms and exam rather than operating on a scan alone. Surgery is only on the table once a specific disc is confirmed as the pain generator, because degeneration that shows on imaging does not always cause pain.
Will I need a fusion, or can my motion be preserved?
It depends on the level and its stability. Where motion can be safely kept, an artificial disc is often preferable. Where the segment is unstable or collapsed, a fusion is the sounder choice. Dr. Melamed recommends the least-invasive option that will actually solve your problem.
Do I have to try non-surgical care first?
In almost all cases, yes. Surgery for a degenerative disc is considered only after rest, therapy, and injections have had a fair trial. Options like PRP and cell therapy may be part of that conservative step before any operation is discussed.
Second opinions welcome
Not sure if surgery is the answer? Neither are we — until we've seen your MRI.
Send your imaging for a personal review with Dr. Melamed. Many patients learn a smaller, muscle-sparing option is on the table.
