什么是腰椎间盘置换术?

腰椎间盘置换术是一种背部或脊柱手术. Your spine is made up of bones called vertebrae that are stacked on top of each other. 椎骨之间的椎间盘就像坐垫一样. They allow the vertebrae to rotate and move without the bones rubbing against each other. The lumbar vertebrae and disks are at the bottom of your spine. Lumbar disk replacement involves replacing a worn or degenerated disk in the lower part of your spine with an artificial disk made of metal or a combination of metal and plastic.

Lumbar disk replacement is often seen as an alternative to the more common 脊柱融合术. 融合术将两个椎骨永久地连接在一起. 腰椎间盘置换术是一项大手术. 需要全身麻醉和住院.

为什么我可能需要做腰椎间盘置换术?

The main reason you would need a lumbar disk replacement is to treat 腰痛. Still, not everyone with 腰痛 is a good candidate for this surgery. Your healthcare provider will need to do some tests to see if it’s right for you.

在下列情况下，你可能需要做这个手术:

• Your back pain mostly comes from only 1 or 2 disks in your lower spine.

• You have no major joint disease or compression on the nerves of your spine.

• 你没有超重太多.

• 你以前没有做过脊椎手术.

• 你没有脊柱侧凸或其他脊柱畸形.

腰椎间盘置换术有哪些风险?

和所有手术一样，腰椎间盘置换术也有一定的风险. A disk replacement needs greater access to the spine than standard lumber fusion surgery. 这也使得手术风险更大.

该手术可能存在的风险包括:

• 人工椎间盘或其周围区域感染

• 人工椎间盘脱位或脱位

• 植入物失败或骨折

• 种植体松动或磨损

• Narrowing of the spine (stenosis) because of the breakdown of spinal bones

• 由于种植体位置不佳造成的问题

• 脊椎僵硬或僵硬

• 由于活动减少，腿上有血块

• 附近神经损伤

There may be other risks, depending on your specific health problem. 了解腰椎间盘置换术的风险和益处. Also discuss any concerns with your surgeon before the procedure.

If you have pain, ask your healthcare provider whether the surgery will ease your discomfort. A lumbar disk replacement usually decreases pain, but does not stop it completely. 了解手术能为你做什么是很重要的.

我该如何为腰椎间盘置换术做准备?

还有身体检查和健康史, 你可能需要拍x光片, 核磁共振或CT扫描, 发片, 血液检查. These help the healthcare provider identify the true nature and extent of your back pain and spinal damage. They may also be needed to get a better view of the spine and decide whether the surgery is right for you. You may need nerve conduction studies and electromyography to see if you have nerve damage.

You may be asked to stop smoking as part of getting ready for spine surgery. Smoking puts you at greater risk for wound infections after surgery. 它还会延缓骨头的愈合. 骨头必须能够愈合，手术才能成功. If you need help to stop smoking, talk with your healthcare provider.

Tell your healthcare provider about all medicines you are taking. This includes prescription and over-the-counter medicines and any vitamins, herbs, and supplements. Some of these may affect things like healing and blood clotting. 所以你可能需要在手术前停止服用.

You will be asked to sign a document called an informed consent. 在签字之前, 您的医疗保健提供者将向您解释风险, 还有你手术的好处, 还有其他治疗选择. 如果你有问题，你会被问到. Write down your questions and have all of them answered before you give your consent to have the surgery done.

Follow any directions you are given for not eating or drinking before surgery. 你可能得在医院住几天. 手术后一段时间内你可能不能开车. 手术后很短的一段时间, 在家里，你可能需要一些帮助，比如洗澡, 沙拉酱, 清洁, 和购物. 你可能需要提前安排.

Talk with your healthcare provider so you know exactly what you need to do before your procedure.

腰椎间盘置换术中会发生什么?

You will have an IV (intravenous) line put into a vein in your hand or arm through which an anesthetic is given. 这药会使你进入深度睡眠. 它会让你在手术过程中感觉不到疼痛. 手术时你得仰面躺着.

A team of surgeons (usually a vascular surgeon and an orthopedic or neurosurgeon) will do the procedure together. 外科医生会在你的腹部开一个切口. Your organs and blood vessels will be moved to the side to allow access to your spine.

The surgeon will remove the damaged disk and put the new artificial disk in place. Your organs and blood vessels are put back in place and the incision will be closed.

手术后, you will be taken to a recovery area for close monitoring until you are awake from the anesthesia. 你还需要静脉注射. You may also have a catheter in your bladder to make urination easier. When you are fully awake and alert, you will be taken to your hospital room.

Talk with your healthcare provider about what you can expect your lumbar disk replacement procedure to be like.

腰椎间盘置换术后会发生什么?

You will probably need to stay in the hospital for a few days after your surgery. 因为腰椎间盘置换术不需要骨头来愈合, the recovery period may be faster than with other back surgeries. 如果你需要的话，会给你开止痛药的. You may be encouraged to stand and walk within the first day after surgery. Your IV and bladder catheter will be removed within a few days of surgery.

You will be shown how to move correctly and how to do exercises, such as gentle trunk twists. 这会让你的脊椎保持柔软. It will also help you have a quicker rehabilitation and recovery. As your recovery progresses, you’ll be encouraged to walk and stretch. You’ll need to stay away from any jarring activities or motions for quite a while. 你的恢复可能需要几周到几个月的时间.

腰椎间盘置换术一般能减轻疼痛. 但这并不能完全阻止它. Talk with your healthcare provider to get a realistic idea about what you can expect after this surgery. Also talk with your provider about instructions you need to follow after surgery, such as:

• 你能做什么，不能做什么

• 如何护理你的切口

• 你需要注意哪些问题的迹象

• 当你需要跟进你的医疗保健提供者

• 什么样的生活习惯可以让你的脊椎保持健康. For example, this might be exercising, staying at a healthy weight, and not smoking.