Persistent pain following lumbar disc replacement.

Background: Pain patterns associated with the facet and sacroiliac joints following lumbar total disc replacement correlate with biomechanical modeling observations, such as load transfer to the posterior spinal elements in total disc replacement with an artificial disc. When conventional treatment options are exhausted, spinal cord stimulation (SCS) offers clinically favorable outcomes to treat intractable pain.

Objectives: To contribute to the literature on neuroaugmentive techniques and on pain following disc replacement, and to highlight recent advances and forward-thinking concepts for nonsurgical intradiscal therapies.

Results: Three years of injection therapies and physical therapy did not significantly alleviate the patient's pain. A trial period of SCS rather than reoperation (fusion surgery) was elected. A constant-current multiple source SCS system was implanted. At 12-month follow-up for this system, the patient's pain had been reduced by more than 75%, and the patient reported improved quality of life, including a return of restful sleep.

Conclusions: SCS is a viable technique to control pain associated with artificial disc implant.