Post-Operative Care for Lumbar Artificial Disc Replacement Surgery
If you are considering lumbar artificial disc replacement surgery for chronic low back pain, you may already know that it can reduce your pain levels and improve your quality of life.
The key to faster recovery after surgery—and returning to work and your usual activities sooner—is to follow the instructions provided by your health care team.
While these vary slightly from doctor to doctor, here is an overview of what you should expect, all the way from recovery room to returning to the activities that you enjoy most.
Managing Your Pain
A big part of recovery is getting enough rest. This can be difficult if you are in pain. During your stay in the hospital, your doctor will treat your pain with one or more medications, such as:
- Opioids: These reduce how you perceive pain. They may be given through an IV or as a pill.
- Local anesthetics: These injectable drugs cause a temporary loss of sensation in one part of your body.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): These reduce inflammation that can make your pain worse. They include ibuprofen, naproxen and celeboxib.
- Other pain medications: Other drugs can relieve your pain, such as acetaminophen and ketamine.
Your doctor may also prescribe a pain medication to ease your recovery after you leave the hospital. This is often an opioid drug.
Opioids are powerful pain medications, but have many side effects, including a risk of misuse. Opioids are also not usually recommended for long-term use. If you are prescribed an opioid pain medication, your surgeon will work with you to stop or reduce this medication based on the speed of your recovery.
After you have stopped taking the opioid medication, your doctor may transition you to an over-the-counter pain medication. Your healthcare team can guide you on what to take. If your pain worsens at any point, talk to your doctor.
Learning to Move Safely
In order for you to recover after lumbar artificial disc replacement surgery, your spine needs to be properly aligned — so twisting your back and bending at the waist are not allowed.
Your physical therapist will help you learn how to move more safely. Some things to keep in mind:
- Getting out of bed: You will learn a “log-rolling” technique to get out of bed without twisting the spine.
- Heavy lifting: Right after surgery, you shouldn’t lift anything heavier than five pounds. As your muscles grow stronger, you will be able to slowly return to lifting more weight.
- Showering: Your surgical incision should stay dry until it is fully healed, about two weeks after surgery. Avoid taking baths and cover the incision with a bandage when you shower. You should use a shower chair and stool while in the shower to protect your spine from falls or sudden movements. You may also want to have someone nearby to help you get in and out of the shower.
- Driving: You will not be able to drive until your pain is under control. You also can’t drive while taking opioid pain medications.
Returning to Work
After artificial disc replacement surgery, your main job is to rest, so you should plan to not work right away. How long it takes for you to return to work depends on the type of work that you do.
If your job involves light activities, you may be able to return to work within two to three weeks. For more physically demanding work, expect at least six weeks. If your job includes heavy lifting, you may need to wait at least 12 weeks before going back to work.
Also, if your job involves driving, you will not be able to do it while you are on opioid pain medications.
Resuming Physical Activities
Soon after surgery, your healthcare team will encourage you to start walking to speed up your recovery. From then on, you will need to slowly work up to your regular activities and exercise. While everybody's recovery is a little bit different, many patients can expect something like the following:
- Two to four weeks after surgery, a physical therapist will typically start working with you on developing the strength, stability and aerobic fitness that you need to return to your being active. Continue to do your physical therapy activities each day.
- Many people will be able to return to light exercise and recreational sports at about six weeks after surgery, although your physical therapist might ask you to wait longer. Avoid impact sports until your healthcare team has told you it is okay. Walking, though, is always a good way to stay active.
- After surgery, you can resume sexual activity when you feel ready, as long as it doesn’t involve twisting or bending at the waist. If a position hurts, don’t do it. If you are unsure about any sexual activity or position, talk to your doctor before attempting it.
During recovery, remember not to twist your back or bend at the waist while moving. You should also talk to your doctor or physical therapist about how much weight you can safely lift. It may be less than you expect.
Recovering at Home
You will be sent home a few days after your artificial disc replacement surgery. Your healthcare team will give you instructions on how to take care of yourself during the first couple weeks at home. This includes information on:
- Changing your bandage: Your doctor or nurse may show you how to change your bandage, unless you have a health care professional visiting you regularly. The incision should stay clean and dry to avoid getting an infection.
- Medications: If you still have pain or nausea, your doctor may prescribe you medications or recommend an over-the-counter drug. If you have questions about your medications, call your doctor’s office.
- Follow-up appointments: You will have a follow-up visit with your doctor around three weeks after surgery to check your symptoms and overall health. You may also have X-rays or other medical imaging to check the artificial disc device.
Planning ahead can make your recovery safer and more restful. This includes asking family or friends to take care of your needs at home, drive you when you need to go to your doctor’s appointments, or pick up your prescriptions.
Setting up the space around your bed can also make recovery more restful. Keep everything you will need nearby, such as telephone, books or magazines, clothing, toiletries, snacks and drinks.
Keep your walker or other assistive device near your bed so you can easily get to the bathroom when you need to. Ask your caregiver to be nearby the first few times so they can assist you.
If you develop any of the following symptoms, call your doctor:
- Bleeding, redness, swelling, or discharge from your incision site
- Pain that does not respond to pain medication
- Numbness or weakness
- Difficulty swallowing
- Voice change or hoarseness
- Difficulty breathing
Because artificial disc replacement surgery doesn’t require the bones of the spine to heal, recovery after this procedure is faster than for other back surgeries, including spine fusion.
Full recovery from artificial disc replacement surgery will take anywhere from a few weeks to a few months. This includes a period of limited motion and some discomfort for a few weeks after surgery, followed by several weeks of rehabilitation. As your body heals, you will be able to slowly add more activities to your daily routine.
Artificial disc replacement recovery time depends on many factors, including your overall health, whether you smoke cigarettes, and how well you are able to follow the instructions and rehabilitation program prescribed by your physician and physical therapist.
Success over the long-term
Once you have resumed your normal activities, there are other lifestyle changes that you can make to ensure your long-term success. These include:
- Quit nicotine: Smoking contributes to back pain, and nicotine can interfere with the healing process.
- Avoid excess alcohol: Alcohol is a depressant that can affect your moods. It can also interact with certain medications.
- Drink water: Some medications can cause constipation, so drink plenty of water throughout the day.
- Mange your weight: Excess weight can put more pressure on the discs in your low back. Eat healthy and stay physically active to maintain a healthy weight.
- Get plenty of sleep: Sleep is essential for the healing process. It will also keep you healthy long-term.
By following the instructions given to you by your health care team, sticking with your physical therapy and getting plenty of rest, your recovery after lumbar artificial disc replacement surgery will be faster and safer. That means you can get back to living your life fully that much sooner.