Disc Replacement in a Teenager?

by Chris Centeno, MD /

Receive a Regenexx® Patient Info Packet by email and learn why it's a superior regenerative solution.

disc replacement in a teenager

Is disc replacement in a teenager a good idea? Is fusion smart or dumb in this age group? This was the dilemma facing Analisa, a 20 year old young woman with a bad low back disc. In the end, she used advanced regenerative spine care to avoid both surgeries.

Analisa had a painful disc at L3-L4 that was degenerating, despite being in her late teens. The discs act as shock absorbers between the bones of the spine (vertebrae). They can become degenerative and can sometimes be painful in patients who have had trauma or just with the wear and tear of life. What’s less common is that one would become a problem in a teenager, but hers started to be an issue at the age of 12.

When I first evaluated her in February of this year, she was miserable. Her L3-L4 disc was no longer holding onto water on her MRI (dark disc) and a discogram had shown it to be causing pain. She was at a very low level of function and was spending every day in bed and couldn’t walk long enough distances to go shopping. One local surgeon had told her she needed a fusion of that disc, which is a surgery where the disc is removed and hardware and bone solidifies that level so it no longer moves. Another surgeon had told her she needed a disc replacement, a surgery where this disc is also removed and then an artificial metal/plastic disc is inserted. Thankfully for her, her insurance company had more sense than the surgeons, as they denied both procedures. Why was each of these surgeries a bad idea?

As I tell all of my patients, fusion is a dog with really big fleas. What I mean is that when you fuse a spinal segment that was built to move as part of a coordinated machine that moves (the spine), you get a broken machine. The part that’s fused invariably overloads the parts above and below, causing new problems. A disc replacement is a surgery designed to try and fix the problems of fusion, by installing a hockey puck sized device that allows some motion. The problem is that not only is this a big surgery, but in teenagers, the device will have to be replaced many times throughout their lives due to wear and tear. Each surgery will be a bigger and uglier affair and have ascending risks for the patient.

So what did we do? We ditched the idea of both surgeries and used her stellar 20 year old growth factors found inside her own platelets to treat the irritated nerves around the disc and tighten the loose and degenerative ligaments at that level. This was a series of precise image guided injections without surgery. The results? She now only spends 1-3 days a month resting in bed, her legs no longer throb, and she can walk distances, so shopping is a go!

The upshot? Fusing the low back of a teenager is a dumb idea. I’ve seen it happen a few times in my practice (not under my watch) when young patients, in more pain than ever, came into my practice having had their back fused by an overzealous surgeon. Replacing a disc in someone so young isn’t much smarter. In this case, the patient’s insurance company pushed her toward a better option. While I’m no fan of insurers, we are seeing them take a harder stance on fusion and given that I would estimate that only 10-20% of patients who get this nasty surgery actually have no other good choice, that’s not a bad thing!

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
View Profile

Get Blog Updates by Email

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
Select Your Problem Area
Shoulder

Shoulder

Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Before considering shoulder arthroscopy or shoulder replacement, consider an evaluation of your condition with a regenerative treatment specialist.

  • Rotator Cuff Tears and Tendinitis
  • Shoulder Instability
  • SLAP Tear / Labral Tears
  • Shoulder Arthritis
  • Other Degenerative Conditions & Overuse Injuries
Learn More
Cervical Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Knee

Knees

Knees are the target of many common sports injuries. Sadly, they are also the target of a number of surgeries that research has frequently shown to be ineffective or minimally effective. Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. They can even be used to reduce pain and delay knee replacement for more severe arthritis.

  • Knee Meniscus Tears
  • Knee ACL Tears
  • Knee Instability
  • Knee Osteoarthritis
  • Other Knee Ligaments / Tendons & Overuse Injuries
  • And more
Learn More
Lower Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Hand & Wrist

Hand & Wrist

Hand and wrist injuries and arthritis, carpal tunnel syndrome, and conditions relating to overuse of the thumb, are good candidates for regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Hand and Wrist Arthritis
  • Carpal Tunnel Syndrome
  • Trigger Finger
  • Thumb Arthritis (Basal Joint, CMC, Gamer’s Thumb, Texting Thumb)
  • Other conditions that cause pain
Learn More
Elbow

Elbow

Most injuries of the elbow’s tendons and ligaments, as well as arthritis, can be treated non-surgically with regenerative procedures.

  • Golfer’s elbow & Tennis elbow
  • Arthritis
  • Ulnar collateral ligament wear (common in baseball pitchers)
  • And more
Learn More
Hip

Hip

Hip injuries and degenerative conditions become more common with age. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time. Whether a hip condition is acute or degenerative, regenerative procedures can help reduce pain and may help heal injured tissue, without the complications of invasive surgical hip procedures.

  • Labral Tear
  • Hip Arthritis
  • Hip Bursitis
  • Hip Sprain, Tendonitis or Inflammation
  • Hip Instability
Learn More
Foot & Ankle

Foot & Ankle

Foot and ankle injuries are common in athletes. These injuries can often benefit from non-surgical regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Ankle Arthritis
  • Plantar fasciitis
  • Ligament sprains or tears
  • Other conditions that cause pain
Learn More

Is Regenexx Right For You?

Request a free Regenexx Info Packet

REGENEXX WEBINARS

Learn about the #1 Stem Cell & Platelet Procedures for treating arthritis, common joint injuries & spine pain.

Join a Webinar

RECEIVE BLOG ARTICLES BY EMAIL

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Subscribe to the Blog

FOLLOW US

Copyright © Regenexx 2019. All rights reserved. | Privacy Policy

*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.

Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.