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 The Artificial Disc Prosthesis Operation |
How does the implantation of an artificial lumbar disc work?
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Animation ADR |
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Shortly before surgery you will get antibiotics to prevent infections and a low molecular weight heparin injection to prevent thrombosis. The disc prosthesis implantation is performed in general anaesthesia in the supine position. The incision is mostly vertical below or above the belly-button, 7-25 cm depending on the abdominal girth and location of the degenerated disc. The fatter the belly the longer the skin incision. Sometimes a transverse skin incision is cosmetically preferred, but generally a vertical incision is necessary, with a better cosmetic result. After skin incision, proceeding to the spine by an a-traumatic anterior retroperitoneal approach: passing the intestines without touching or viewing them. The intestines remain hidden and enclosed in the intact peritoneal membrane, they are not at risk. After the big blood vessels are set aside gently (the risk of vascular injury is very low and well controlled) the "degenerated" disc is easily cleared and fenced off. Now the anterior part of the disc is opened, preserving the annular ring as much as possible and the degenerative contents can be removed. The cleaned intervertebral space is gently spread by distracting instruments: if necessary remnant herniated disc pieces are removed piece by piece out of the dorsal area and spinal canal. The cleaned intervertebral space is filled out with the implant: the "artificial disc".
The Artificial Disc immediately anchors firmly in place, because of the powerful natural intra spinal pressure, preventing any dislocation. The wound is closed in layers, mostly left with a small draining tube to catch up redundant blood. Now the patient can wake up. The back can be strained directly, walking is immediately permitted. It is advisable to reduce the intake of food to a minimum after surgery to prevent vomiting from overloading the bowels. You can take up your normal diet as soon as you feel fit and the abdomen is rumbling; normally the day after surgery. Nevertheless no extra rest is necessary. You can come out of bed within one hour after surgery and simply walk to the toilet. Generally the drainage can be removed after 24-48 hours. The spine and deep wounds are supported by a small corset only during daytime. Further hospital stay generally lasts 2-3 days.
Besides the new "wound pain" it may occur that former pains still remain during the first three to six months. On the other hand the "old" pain can disappear as “snow in the sun”. The largest risk however is the continuing of the former pain. The outcome remains especially linked to an exact and proper diagnosis combined with an outstanding surgical repair, quality of the artificial disc and positioning of the implant. Experienced surgeons clearly show better results.
In most cases the stitches do not need to be removed, they will disappear automatically. Special rehabilitation is not required and there are no restrictions imposed. As soon as the wound is healed you can drive your car and cycle again. It is important to keep your body in a good shape. |
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