Description

Lumbar Disc Replacement is emerging as the new treatment for some types of low back pain and one of the latest advancements in spinal surgery.

As spinal discs degenerate, they may become painful, thus limiting function and decreasing the quality of life for individuals.

Lumbar disc replacement is similar to other types of joint replacement (such as hip and knee replacements). The concept is similar in that the surgeon is removing a damaged joint, and replacing this with a metal and plastic implant. In the lumbar spine, the goal is to remove the damaged, painful disc, and replace this with a metal and plastic implant. The implant is designed to move like a normal disc.

The theoretical advantage of lumbar disc replacement over spine fusion is that the replaced disc would allow motion at the damaged level and would not transfer stresses to adjacent levels. The goal is to achieve the same pain reduction as spinal fusion, but eliminate some of the complications.

Before the procedure

• You will undergo a series of blood tests, X-rays and a MRI scan
• You will meet the anaesthetist prior to the surgery.
• You will be asked to stop smoking prior to surgery. In smokers the spinal fusion fails twice as often as in non-smokers because the blood supply to the disc is affected.
• You should stop taking oral contraceptive pills two to three weeks prior to surgery as they can increase the risk of blood clots in your legs
• Stop taking anti-inflammatory tablets a week before surgery as they can cause excessive bleeding during surgery
• Let your surgeon, anaesthetist and nursing staff know if you are allergic to any medicines
• You will need to inform your medical team of ALL your current medical problems and medication. If you are on blood thinning medication such as Warfarin – you must notify us. If you have any infections or coughs and colds at the time you cam for surgery, please let the team know. If you have high blood pressure or diabetes, make sure it is well controlled leading up to your surgery
• Gather knowledge about your operation. Ask questions and speak to other patients from the Spinal Support Group (link to Spinal Support Group pages) so you are completely relaxed about what is going on. The more relaxed and positive you can be before surgery, the better you will recover from it
• Try and stay as active and fit as possible prior to surgery.

During the procedure

• An incision is made in the abdomen to expose the front part of the spine
• Live X-ray is used to determine the correct level(s) to be operated on
• The disc is approached after carefully separating away the abdominal contents and major blood vessels are moved to one side
• The disc is removed
• A disc replacement device is implanted
• Normal compression of the spine will hold the implant in place
• Surgery takes approximately 1 – 3 hours

After the procedure

• You will be in the recovery room for 1 – 11/2 hours
• After going to your hospital room, you will be able to use a PCA pump to get medication for pain control. This machine controls the amount of medication to be received
• Staff will usually get you out of bed the same day as the surgery
• The hospital stay is usually 1 – 2 days
• You will be given any prescription medications and discharge instructions
• You will be able to ride in a car upon leaving hospital – but should not probably drive for the first week following surgery
• The most important thing is to keep active and mobile and not remain in one position for too long. Prolonged bed rest is NOT recommended
• Physical therapy is usually initiated after your first follow up appointment with the consultant