Lumbar pain, or lower back pain, is a common cause of chronic pain among adults in the United States. Artificial disc replacement and spinal fusion are surgical treatment options for people whose back pain is the result of disabling conditions that include advanced disc disease, disc herniation and other degenerative spinal conditions. Recovery times vary depending upon the procedure used.
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Consider factors including your goals, needs for mobility versus stabilisation and anatomical abnormalities, which influence the choice between an artificial disc replacement and spinal fusion for lumbar pain.
Decide with your physician whether your spine requires stabilisation or not. People with significant or widespread spinal instability (sometimes the result of a degenerative form of scoliosis called "spondylolisthesis") may require spinal fusion. This procedure has the advantage of providing spinal stability by limiting movement of the vertebrae.
Ask your physician if you have a single degenerative disc. If so, you may be a candidate for artificial disc replacement. This procedure seeks to reduce pain from a degenerative disc and improve spinal mobility. If you have more than one disc that's causing pain, a fusion may be more appropriate.
Consider the advantages of each procedure. Spinal fusion is an older procedure, but disc replacement is a more conservative procedure. First, it preserves mobility because rather than fusing the spine together, a single disc is replaced. The artificial disc functions much like any other disc in the spine, which allows for normal range of motion. Also, in spinal fusion patients, there may be additional disease or deterioration near the fusion site. Artificial disc replacement may prevent this type of future degeneration.
Choosing Disc Replacement or Fusion
Try to be active during recovery from artificial disc replacement. Most people are usually able to walk the same day as the surgery and often require as little as up to two days in the hospital.
Restrict activity for the first month after surgery and implement a walking and stretching program. These programs are typically self-directed and aimed at increasing fitness and flexibility.
Return to your normal activities six to eight weeks after surgery, unless your physician advises you differently. Your physician will probably continue to monitor recovery progress during the first year after the procedure.
Recovering From Artificial Disc Replacement
Remain at the hospital for up to two days. Your medical team may conduct blood tests after surgery to make sure your blood oxygen levels are acceptable. You may also be fitted with a back brace, which limits spinal motion and allows the bone fusion to grow.
Be as mobile as possible after discharge. Ask your physician about taking short walks as you recover. You may need to avoid twisting movements and refrain from lifting heavy objects.
Increase your activity levels slowly. From one to three months after the procedure, you should still avoid bending, twisting and lifting. Your physician may ask you to wear a back brace for up to three months. With your physician's approval, begin to increase your activity level. Patients who are able to be physically active tend to have more successful fusions.
Begin physiotherapy after about three months. If you have a job that requires heavy physical activity, physiotherapy can help you get back to work safely. In any case, a progressive stretching and strengthening program can help you strengthen your trunk muscles, which support the spine.
Recovering From Spinal Fusion
Tips and warnings
- When selecting a surgeon, seek recommendations from friends and family and find someone with whom you're comfortable.
- Seek a second opinion before consenting to any surgical procedure.
- After surgery, watch for signs of infection, which include increased pain, fever and redness or drainage at the incision site.
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