Disc Replacement

Lumbar disc arthroplasty

Low back pain and degenerative disc disease to L4/5 and or L5/S1


Pre-operative questionnaire
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Special preparation for surgery
Stop all blood thinning medications including aspirin, warfarin, clopidogrel.
Stop HRT and oral contraceptives. Stop some herbal medicines.
You will be advised when to stop these medications.

Admission to hospital
Night before surgery or on the day of surgery

General anesthetic

Operation position
Supine (on back)

Details of operation
Incision is made below and to the left of the umbilicus (belly button). Approach is made to the spine by retracting (holding out of the way) the abdominal contents. Special self retaining spinal retractors are used to gain a safe corridor down which to access the disc. The disc material is removed with specialized instruments.
The total disc replacement procedure involves insertion of the replacement disc with special instruments and under x-ray guidance. The disc is inserted together with a specially designed spacer to allow movement at the vertebral level.

Length of surgery
1.5 – 3 hours

Urinary catheter required

Post-operative drain required

Post-operative antibiotics

Post-operative iv fluids (drip)
Yes Intravenous fluids and patient controlled analgesia

DVT prophylaxis
Yes – details tailored to individual patient

Mobilization after surgery
12 hours

Length of stay in hospital
1- 3 days

Post hospital recovery
2 weeks of gentle rest followed by 2 weeks gradually increasing to normal daily activities and a further 2 weeks of increasing to full activity level. Leave strenuous activities until after 6 weeks.

Sutures removed


Review appointment
6 weeks with x-ray
12 weeks with x-ray
6 months with x-ray
1 year with x-ray
and then annual review


Return to driving
2-4 weeks

Return to work
4- 6 weeks