This procedure is aimed at relieving pain caused by discogenic pain in the lumbar area. This is achieved by replacing a diseased disc with a metal prosthetic disc. The new disc is designed to restore disc space and height, to restore flexibility and to minimalise the risk of disc degeneration. The discs are manufactured in various sizes your consultant will choose the most appropriate for you.

At present this surgery is undertaken through an anterior approach, i.e. via your abdomen.

Your Hospital Stay

On average your hospital stay will be 5 days. You may be required to come into hospital the day before your surgery in order to have pre surgery bowel prep. The first night post surgery will be spent in intensive care (ICU) or high dependency (HDU). This will enable staff to closely observe you overnight and allow you to receive one to one care.

You will be able to sit up a few hours post surgery and lie on your side if that is more comfortable. You will be encouraged to drink fluids once the anaesthetist and the surgeon are happy that your bowel is functioning okay. If you are tolerating fluids okay you will be told when you can commence on a light diet. When the anaesthetist and surgeon are happy with your status you will return to the ward.

The first day post operation, surgeon guidelines permitting you will be seen by the physiotherapist and commenced mobilising very slowly. The proceeding days you will be assisted to mobilise, each day mobilising more frequently and undertaking more tasks independently, i.e. washing and dressing.

During your stay you will be seen by the clinical nurse specialist daily, Monday to Friday and she will be able to answer any queries or concerns.

Medication

On discharge you will be given 1-2 weeks of analgesia and any other required medications. It is advisable that you continue taking you analgesia for at least 2 weeks post discharge. With most analgesia it is advisable to take a laxative as all analgesia has a constipating effect. If you require further medications your GP should be able to write a prescription or your consultant in your follow up appointment will be able to prescribe further medication.

Mobility

Prior to discharge you should be as independent as you were pre surgery. You will be assessed mobilising up and down stairs safely before you are discharged.
Post operation your surgeon will want you to wear a canvas corset. This is to be worn when sitting and mobilising, it is not necessary to wear when lying in bed. The corset will need to be worn for approximately 6 weeks; it is surgeon preference for the duration. When sitting a high backed chair is preferable to a low sofa. Initially sitting may be uncomfortable; it would be advisable to sit for 20 minutes at a time until you are more comfortable.

Travelling

Driving: This is at your surgeon’s discretion. 3-4 is most common practise to abstain from driving. You need to be able to perform an emergency stop safely. You are able to be a passenger in a car post surgery. Sit in the passenger seat, seat reclined and a cushion for support if comfortable. If the journey is greater than 45 minutes have a break, stretch your legs at regular intervals.

Flying: This can be discussed with your consultant. 6 weeks is most common practise for short haul flights and 12 weeks for long haul flights. When flying it is advisable to recline your seat and regularly walk up and down the gangway.

Returning to Work

Your consultant will advise you on this, 6 weeks is advisable. When returning to work, if possible graduate your return; a few hours a day for a few days a week. If it is necessary to use public transport, i.e. the underground travel at quiet times, early morning or late morning, avoid rush hour. If you are in a sedentary job regularly stand and walk around. If you have an active job you may require a longer period off work and consider lighter duties on your return.

Exercise

Walking is initially the best exercise for you, each day increase the distance you are walking. Your consultant will not want you to undertake any formal physiotherapy until 12 weeks post surgery. When you do return to the gym gradually build up your activities.

Do not lift anything over 3 Kg in weight. No bending and no twisting until advised otherwise. No housework.

Wound Care

Your wound will have been closed with either staples or steristrips; these are removed at 10-14 days post surgery. You will be advised pre discharge of how to care for your wound. Ideally the dressing should be changed every 3-4 days. You will have been given several waterproof dressings to go home with. You can shower but not bathe until you have been reviewed.

If you have staples these should be removed by your practise nurse as advised. Once the staples have been removed the wound can be left uncovered and it is okay to get the wound wet.

All information given is guidelines and may vary from patient to patient.