Spinal Surgery
Spinal surgery is an option for patients who suffer from back pain that haven't responded to conservative (non-surgical) treatment, especially if the pain and other symptoms make it difficult to do everyday activities.
Here is the information you need to know if you are considering having a lumbar or cervical artificial disc replacement.
Your spine is made up of small bones, called vertebrae, which are stacked on top of one another and create the natural curves of your back. Between each vertebra is an intervertebral disc, which, simply put, acts as a shock absorber for your spine, making it possible for you to stand, bend, and move. These discs are very important in the spinal structure, but as we age they start to deteriorate and lose their shock absorption abilities. This may cause pain and wear and tear on the vertebrae.
An artificial disc replaces a disc between the vertebrae in the spine that are diseased - in the neck (cervical spine) or lower back (lumbar spine.) Similar to hip or knee joint replacements, a disk replacement substitutes a mechanical device for an intervertebral disk in the spine. The device is meant to restore motion to the spine by replacing the worn, degenerated disk.
Artificial disk replacement is a newer surgical procedure for relieving back pain and is used as an alternative to the usual surgical fusion operation.
Speak to your doctor about which procedure is best for you
While the artificial disc replacement offers many benefits and advantages over the spinal fusion procedure, it is important to understand that the disc replacement surgery is still the newer technology. It is always best to discuss the options available with your doctor to decide which procedure is best for you.
Possible complications with disc replacement surgery
There are always risks with having any operation and this is no different for artificial disc replacement surgery. You should know that these include infection, bleeding during or after surgery due to injury to blood vessels, pain, and blood clots. These are all general complications of any surgery.
Complications specific to disc replacement surgery include continued pain due to nerve injury. Nerve injury can also cause numbness, loss of bladder and bowel control, and sexual dysfunction in men. The artificial disc could move out of place or break and there can be wear on the disc materials. Your doctor will discuss these risks with you and may be able to tell you if you are at a higher risk for these complications.
About the operation
The operation is done from the front of the body. You will lie on your back for the procedure. For the cervical disc, the surgeon makes a cut (incision) through the skin and muscles of the front of the neck, while for the lumbar disc replacement, the doctor works through a cut in the abdomen (belly). The blood vessels, and organs are moved to the side so that the surgeon can see the front of the spine. An x-ray (fluoroscope) will help the surgeon to identify the disc that is to be replaced. A final x-ray will confirm that the disc is in place and working.
Different cervical artificial discs | |
Different lumbar artificial discs |
Getting ready for the operation
There are certain things that increase the risk for you to have complications. You can reduce or eliminate these risk factors as far as possible.
If you smoke you should stop immediately. Nicotine, and other drugs, may affect the way your body reacts to the anaesthetic and also prevent the operation wound from healing properly, which may increase pain. You may also develop unsightly scarring. Stopping smoking at least two weeks before having the operation reduces your risk of heart and lung problems.
Its very important to tell your doctor about all the medicines youre taking, including blood-thinning medicines, diabetic medicine as well as any medicine you by over the counter. Your doctor will tell you which ones you can carry on with and which ones you should stop.
Your doctor may discuss the possibility of you needing a blood transfusion during or after the operation. You may need to sign consent to this.
Chances are that you will go into hospital early in the morning, on the day of your operation. Your doctor will have told you not to eat or drink after a certain time. If you have diabetes follow the instructions your doctor gave you.
Your recovery afterwards
How long you stay in hospital will depend on how quickly you recover, but most people can go home by the third day after surgery.
Most patients are able to get out of bed and walk within a few hours after surgery, usually with the help of physiotherapist to show the proper way of moving. Depending on the surgery, you may have to wear a brace, or soft collar for cervical disc replacement to support the muscles.
As you recover in the hospital, the healthcare team will show you ways to move, dress, and do activities without putting extra strain on your neck or back.
You will need to follow up with your surgeon afterwards. X-rays will be done from time to time to make sure the artificial disc is still in its proper place.
Your surgeon will let you know when you can return to work. Depending on the type of work you do, this should be in about two to four weeks. If your job requires moving and lifting heavy items, you may need a longer period of recovery.
Your surgeon will tell you when it's okay to do all your work and recreational activities. You may have to change the way you do things, such as not spending long periods of time in one position when reading, sewing or doing other handwork.
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