Lumbar Artificial Disc Replacement

 

 

Lumbar Artificial Disc Replacement (ADR) is a surgical procedure in which one or more of the lumbar discs is removed through an incision in your abdomen. The disc is replaced with a device that holds the disc-space open and allows the bones to continue to move. This procedure is an alternative to a bone fusion.

If You Have Decided To Have Surgery:

  • Call Dr. Jeffords’ staff to schedule your surgery date and the date for your pre-operative consultation.
  • At your pre-operative consultation Dr. Jeffords or his P.A. will discuss the procedure with you, answer any questions you may have, and have you sign a consent form for surgery.
  • You will be given prescriptions for pain medicine and instructions for post-operative care.
  • Your pre-operative evaluation at the hospital will be scheduled on the same day as your pre-operative consultation. You may have a chest X-ray, EKG, and blood-work performed.
  • You may be asked to have a neurological or psychological evaluation prior to surgery.
  • If you take aspirin or anti-inflammatory medications daily, STOP these medications at least 7 days before your surgery.
  • If you are a smoker you should make every effort to stop smoking as soon as you can before surgery (at least 2 weeks prior to surgery). You should not smoke for at least 6 weeks after surgery.
  • You will check into the hospital the morning of surgery.

Surgical Procedure:

  • Your anesthesiologist will bring you to the operating room and put you to sleep for the operation.
  • There are usually two nurses in the room and a certified surgical assistant that assists Dr. Jeffords with the operation.
  • A general surgeon or vascular surgeon may assist Dr. Jeffords during the exposure of the spine.
  • A small incision is made on the front of your lower abdomen, usually below or to the side of your “belly button”.
  • After carefully moving the muscle tissue and abdominal contents, retractors are placed to expose the front of the spine and hold the major blood vessels off to the side.
  • Dr. Jeffords will then remove the disc and prepare the disc space for the disc replacement.
  • The disc-space is opened and the device is positioned in-between the bones.
  • The device is held in place by small metal teeth or a metal fin, friction between the device and the bone, and by tension across the disc-space created by the ligaments.
  • The incision is closed with resorbable stitches that are placed beneath the skin.
  • The surgery will take approximately 2-3 hours.

After Surgery:

  • You will be taken to the recovery room (PACU) and stay there for about 1-1 ½ hours. Afterwards you will be taken to your hospital room where you can visit with your family.
  • Dr. Jeffords will speak to your family while you are in the recovery room.
  • You will be given a PCA pain-pump which is a machine that you are able to control to help alleviate any post-surgical pain. The following morning you will be switched from this to oral pain pills.
  • The nurses will get you out of bed shortly after surgery and the physical therapists will work with you to ensure that you are strong enough to walk and climb stairs.
  • The hospital stay is usually 2-3 days. Occasionally patients go home the morning after surgery.
  • The hospital therapist will give you a set of exercises to do at home.
  • You will be able to ride in a car or plane upon leaving the hospital.

After Going Home:

  • A small dressing is placed over the incision in the operating room. This dressing will stay on until you see Dr. Jeffords in the office two weeks after surgery.
  • You may shower over the dressing.
  • You will be given pain medication and a muscle relaxant to help control post-operative pain and spasms. Make sure you do not drive or operate heavy machinery while on the medication.
  • You may drive after two weeks once you are off of your medications.
  • You will start a rehabilitation program with the physical therapist 2 weeks after surgery.
  • You can expect to return to sedentary office or desk work approximately 2-4 weeks after surgery.
  • If you perform manual labor that requires heavy lifting or frequent bending or climbing you should wait 3 months before returning to this activity. You can return to moderate duty at 4 weeks.
  • Dr. Jeffords will see you again 6 weeks after surgery and also at 3 and 6 months post-op.
  • X-rays will be taken at each of your post-op visits.
  • Sports activities such as running, golf or tennis may be resumed at 3 months.