(This is the section that explains the details of the operation or procedure above and should be read in conjunction with the section called your back operation).

A lumbar ADA is performed to remove a damaged disc. The aim of the operation is to remove the whole disc and to replace it with an artificial disc. The reason that the disc is removed is because the disc is causing local back pain and referred pain through inflammation or pain down the leg due to the compression of a nerve root.
The idea behind replacing the disc that is removed with an artificial disc rather than fusing that level is to maintain the movement across that level of the spine. It is thought that fusing a level changes the biomechanics of the adjacent level. In short it means that the movement is abnormal and that his causes the adjacent level to become damaged quicker than it would normally do.
The aim with an ADA is to maintain movement in the affected spinal level and prevent added stress on the discs on the adjacent levels.

When undergoing this operation, you will be lying on your back. Your surgeon will make a small cut on your belly. This cut can vary from two or three centimetres to a slightly larger cut and can be an up and down cut or a cut across your belly in the position where the cut is sometimes made for a caesarean section.
The length of the cut is actually immaterial to the success of the operation and a surgeon should never complicate the operation by trying to make the cut too short.

Your surgeon will usually attempt to work down to the vertebrae without entering the abdominal sac by working around it and pulling the abdominal sac and it’s content to one side. On other occasions the approach can be through the abdominal sac. There are important structures such as the bowel, blood vessels and the ureters (tubes from the kidney carrying the urine to the bladder) and nerves that your surgeon must carefully avoid in this operation.
When the vertebrae are encountered, the disc is removed totally. Thereafter a artificial disc prosthesis is placed in the space. This has do be done carefully under guidance of an X-ray machine to ensure that the disc is perfectly placed. The biggest reason for failed operations are the misplacement of the disc. Therefore the placement is crucial. Following the placement of the prosthesis the wound is stitched up.

Ward care

You would be expected to get out of bed quite early and usually on the first day following surgery or even on the same day. You may usually walk around as much as you want. It is important that you eat and drink nothing until your surgeon specifically allows you to. The reason for that is the possibility of your gut being temporarily paralysed from the surgery. This is mostly because of the traction that is placed on it during surgery to keep it out of the way when the surgeon tries to operate around the abdominal sac.

Discharge

You would normally be discharged about a week after your operation but this will differ case by case. Staff at the hospital will take care of your follow-up consultation, analgesia to take home, sick certificate and wound care provisions in the post-operative period.

Rehabilitation

It is incredibly important to get a lot of rest and exercise following your surgery. Do not try to rush back to work. It is important to walk for exercise and also exercise in conjunction with the guidelines from your physiotherapist. You may perform activities only as prescribed by your health care provider. You should refrain from exercises that involve impact for at least three months. This would include jogging, mountain biking and equestrian pursuits.

Follow up

You will usually be seen after six weeks but will be seen earlier if there are any complications. It is important to realise that you will have to protect your back the rest of your life with good back habits. See the section on exercises to see what you can do to keep your back healthy.