Total disc replacement

This procedure aims to relieve pain caused by discogenic pain in the lumbar area 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 minimise the risk of disc degeneration.

The discs are manufactured in various sizes your consultant will choose the most appropriate for you.

Hospital stay

On average your hospital stay will be five days. You may be required to come into hospital the day before your surgery in order to have pre-surgery bowel preparation. The first night post surgery will be spent in our High Dependency Unit (HDU). This allows staff to closely observe you overnight and provides you with one-to-one care.

You will be able to sit up a few hours after surgery and lie on your side if that is more comfortable. Once you anaesthetist and surgeon are satisfied that your bowel is functioning well you will be encouraged to drink fluids. Once fluids are tolerated you can commence with a light diet.

You will be returned to the ward once the anaesthetist and surgeon are satisfied with your progress.

If recovery is sufficient, the day following surgery you will see one of our physiotherapists and commence mobilisation. The proceeding days you will be assisted to mobilise, each day mobilising more frequently and undertaking more tasks independently, such as washing and dressing.

During your stay you will be seen by the clinical nurse specialist daily. They will be able to answer any queries or concerns you may have.

Medication

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

Mobility

In order to be discharged you need to be as independent as you were pre-surgery, if not more so.

It may be necessary to wear a corset post surgery when sitting or mobile for approximately six weeks.

When sitting, a high backed armchair is preferential to a low chair or sofa. Initially sitting may be uncomfortable and it would be advisable to sit for no more than 20 minutes at a time until you are more comfortable.

Driving

Your surgeon will advise, however it is common to abstain from driving for 3-4 weeks. You must be able to perform an emergency stop safely, without harming yourself or anyone else.

You are able to be a passenger in a car post surgery. It is advisable to sit in the passenger seat with the seat reclined and use a cushion for support if comfortable. If the journey is greater than 45mins have regular breaks and stretch your legs.

Flying

Your surgeon will advise, however it is common to abstain from flying for six weeks following surgery 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.

Work

Your consultant will advise you on this, however 6 weeks of rest, away from work, is common. If possible graduate your return to work; a few hours a day for a few days a week. If absolutely necessary to take public transport travel at quiet times, early morning or late morning, avoiding 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 should consider lighter duties on your return.

Exercise

Walking is initially the best form of exercise for you and you should gradually 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 exercise you should gradually build up your activities.

Do not lift anything over 3kg in weight. You must not bend or twist until advised otherwise.

Wound care

Your wound will have been closed with either clips or steristrips (paper strips) which will be removed 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 three days. You will have been given several spare waterproof dressings and may shower but not to bath. If you have clips in situ these will need to be removed by your practice nurse 10 days post surgery. Once the clips, or steristrips, have been removed the wound can be left uncovered and it is okay to get the wound wet.

Information given are guidelines and may vary from patient to patient.

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