DENVER -- Every year, U.S. surgeons perform more than half a million back surgeries to relieve disc-related pain. As many as 30 percent of those patients have recurrent problems.

Orthopedic specialists are now testing a new procedure that might prevent patients from needing a second surgery.

A herniated, or damaged disc in Joann Seaman's lower back was pushing against a nerve. She was not able to sit, walk or bend without feeling intense pain.

"By the time I came home every day, I was close to tears, and the only comfortable position I could find would be laying flat on the floor," Seaman said.

Surgery was the best option. Typically, doctors remove the portion of the disc causing the pain, but it leaves a hole behind. This can lead to another injury.

"At least 10 percent of the patients who have a discectomy will have a re-herniation of that disc," said Dr. Eugene Bonaroti, a neurosurgeon at West Penn Allegheny Health System in Pittsburgh.

Doctors are now testing a device designed to close the gap for good. The new repair system acts like a mini-sewing machine. The tip of the device is inserted into the disc wall. It anchors sutures on either side of the hole and pulls it shut for patients. That means reducing the risk of a second surgery.

"For him to give me the hope that this could keep it from re-herniating, I was excited about that," Seaman said.

Doctors say the repair system cannot be used for every disc surgery. If the hole is too large or too close to the edge of the bone, it won't work.

There's also a chance the device can increase risk of infection or dislodge and move to another area of the body.

BACKGROUND: Herniated discs -- also referred to as slipped or ruptured discs -- are a common cause of pain in the neck, lower back, arms or legs. A disc is a cushion between the bones of the spine. When a disc collapses down on a nerve, that is called herniation.

"When there is a weakness in the wall of the disc, then that soft inner material can push out and push up against a nerve, and that's what gives you radiating leg pain," said Dr. Eugene Bonaroti, a neurosurgeon at West Penn Allegheny Health System in Pittsburgh, Penn.

TREATMENTS: The American Academy of Orthopaedic Surgeons said in more than 90 percent of cases, herniated discs can be treated effectively with nonsurgical treatments. These treatments include rest, over-the-counter pain medications, muscles relaxers, anti-inflammatory medications, cold compresses and heat treatments. If a patient doesn't respond to such treatment, surgery may be recommended.

SURGERY: The most common procedure performed to treat herniated disc is a discectomy, or more recently, the micro-discectomy, which involves removing the portion of the disc that is applying pressure to the nerves. Surgeons can now perform the procedure through one small incision in the back.

"There have been a lot of attempts to improve upon [the micro-discectomy] with new technology, but most of those things haven’t panned out to be better than the standard micro-disc-ectomy," Dr. Bonaroti said.

This standard procedure involves working with an operating microscope through the small incision to trim back the portion of the disc that's coming in contact with a nerve. While effective, this procedure leaves an opening in the disc that sometimes leads to re-injury following surgery. About 30 percent of patients experience pain following a lumbar discectomy and 15 percent require a second surgery (Source: Orthopedics Magazine).

PREVENTING SECOND SURGERIES: A new implant protects a patient from re-herniation by closing the hole left behind after discectomy. The Xclose Tissue Repair System is made of a sterile, braided material made of polyester. The umbrella-like implant is inserted through the opening in the disc and opened up to act as a seal against any material that might try to pass through the opening.

Experts hope the procedure will not only reduce the risk of re-injury, but quicken recovery times for patients.

"Our hope is that by suturing that disc wall back together, we can get people back to regular activities much sooner," Dr. Bonaroti said.

Additional Resource:
Dan Laurent
Public Relations
Allegheny General Hospital
(412) 359-8602