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Last Updated: Saturday, 15 December 2007, 00:49 GMT
'The best 20,000 I have spent'
By Jane Elliott
Health reporter, BBC News

Julie Littler
Julie's life has been transformed
Julie Littler had nearly a decade of excruciating back pain.

Doctors told her she would have to accept life in a wheelchair, but she was determined there must be something that could be done.

Six months ago she underwent a privately funded operation, costing 20,000, to replace a disc in her spine.

Julie, aged 36, from Chester says her life has been transformed.

Her problems started about nine years ago when she started getting pains in the lower half of the back and legs.

The NHS just more or less said take the pills and live with your wheelchair and crutches for the rest of your life
Julie Littler

Doctors initially thought it was sciatica a pain in the main nerve of the leg.

"I struggled with the NHS for years to get something done," said Julie.

"They said that lower back pain was very common, but they never actually found out what was wrong. They just treated the symptoms rather than finding out what was causing it.

"The NHS just more or less said take the pills and live with your wheelchair and crutches for the rest of your life.

"I just kept saying: 'There must be something you can do. You put a man on the moon, you must be able to do something about my back'."

Julie was told by an orthopaedic specialist that one option was a spinal fusion operation - but it was not recommended for someone so young.

The danger was that the area above that fused would deteriorate - and then the area above that.

Given hope

In fact, Julie was told there was only a 50/50 chance that the surgery would be a success.

Then she read a newspaper article about a possible alternative.

Consultant neurosurgeon Jake Timothy, from the Leeds Teaching hospital, was offering a total disc replacement, in which worn spinal discs are replaced with metal and plastic implants.

For selected patients, aged between 20-50 with really serious degeneration of the spine, the surgery can be quite miraculous
Dr Jake Timothy

"When we went to see Jake Timothy his first words were 'Of course there is something we can do,'' said Julie.

Dr Timothy replaced one of her discs, and the mother-of-one says the affects on her health have been dramatic.

"It has been awesome: I have got my life back," said Julie.

"I still have my limits which is a little frustrating, because you tend to think you are bionic.

"But I am waking up in the morning and not reaching for morphine. I can put my socks on. Little things. It is amazing what I can do."

Surgical procedure

Disc replacement surgery has been approved for some patients by the NHS watchdog, the National Institute for Health and Clinical Excellence (NICE).

Worn discs, usually at the base of the spine, are replaced with artificial discs made of cobalt or titanium with a polyethylene core. They are designed to ape as closely as possible the action of original discs, allowing the spine to remain as flexible as possible.

"For selected patients, aged between 20-50 with really serious degeneration of the spine, the surgery can be quite miraculous," said Dr Timothy.

"It is a last resort as opposed to first line treatment. Often these patients have years of non-operative treatment before they have surgery."

The Leeds team have invested in a special simulator to evaluate rates of wear in the different types of replacement disc over the next three years.

They are well aware that hip and knee replacements have proved problematical in the past, and are conscious that similar problems in the spine could be seriously debilitating.

Andrew Quaile, a consultant orthopaedic and spinal surgeon in Hampshire, said the technique had the potential to give patients far better movement than spinal fusion.

However, he warned that the surgery, which involves going in through the abdomen, rather than the back, and moving the bowel, was complex, and accurate placement was absolutely key.

The Arthritis Research Campaign provided 84,000 towards the Leeds team's simulator.

A spokesman said: "New surgical techniques are increasingly bringing relief to younger patients with severe low back pain, but it's essential that they are tested and evaluated properly, which is why we've funded this piece of equipment."

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