Is total disc replacement experimental surgery? Not at all. Total disc replacement surgery has been performed for over 20 years and, over that time, the surgical technique and the technology has been refined significantly. There is now a large body of published evidence from across the world, including here in Australia, confirming the effectiveness and durability of total disc replacement surgery. How is the surgery performed? The intervertebral discs are on the front of the spine so, for the lower back, the surgery is performed through a small minimally invasive incision in the lower abdomen. This anterior approach has many advantages: no muscles are cut, stripped, or split (which aids in a faster recovery from surgery), the operation can be performed in a relatively short time with minimal blood loss, and there is minimal risk of nerve damage (as the spinal nerves are on the back and side of the spine, not the front). What is the recovery period and what are the restrictions after surgery? Recovery after total disc replacement surgery is relatively quick. In general, patients are up and walking the day after surgery. Our patients have a brief stay in hospital for postoperative observation, pain relief and to work with our team from Physio Next Door to ensure that they are able to safely return home. It is essential, for an optimal result, that patients to continue to participate in a physiotherapist supervised rehabilitation program after their discharge. Total disc replacement surgery is designed to get people back to normal life and, from around three months post-surgery, there are no particular restrictions and patients generally can go back to all their usual activities of daily living. Is everyone with low back pain a candidate for total disc replacement surgery? Not everyone is a suitable candidate for total disc replacement surgery. Surgery is only appropriate in those people whose pain is significantly interfering with their life and when non-operative treatments, such as physiotherapy, have failed to improve their symptoms adequately. If surgery is indicated, it is the surgeon’s job to match one of the many surgical technologies available today with the individual patient’s clinical problem. Total disc replacement is just one of the many technologies available to spine surgeons today but, in my opinion, it is an excellent surgical treatment option in clinically appropriate patients with chronic low back pain. TOTAL DISC REPLACEMENT ASSISTANT PROFESSOR Laurence McEntee works with Associate Professor Matthew Scott-Young at Gold Coast Spine. Both are orthopaedic surgeons and fellowship trained spine surgeons, specialising in all aspects of adult spine surgery. Gold Coast Spine is widely regarded as the leading centre for total disc replacement surgery in Australia and as one of the leading centres worldwide. 20 Pindara Magazine 2016
Pindara Private Hospital Magazine - Issue Eight
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