Specialized Care

 




Total Disc Replacement - Cervical (TDR)

Patient Guidelines Following Cervical Total Disc Replacement

Please follow these general guidelines after your surgery. If you have any questions regarding your particular situation, please do not hesitate to ask your provider.
 
Care of Incision

Bathing: For the next three to six weeks, you will need to shower and avoid tub baths.  Initially, you may want a stool to sit on during your shower, as you have done in the hospital.  Have everything you need at a height you can reach, and do not attempt to pick up items that are dropped.  For at least one week after surgery, you will need to cover your incision with plastic wrap (e.g. Saran Wrap) and tape, unless otherwise instructed by your physician.
 
Dressings: You should change your dressings daily.  Using a light gauze dressing is fine.  Keeping the insision site dry is very important.  The best time to change the dressing is after showering, but if it becomes wet between showers, change as needed.  If you have staples along your incision, they will be removed the first time you are seen in the office.  Small strips of tape known as Steri-Strips, may be placed across your incision.  They will eventually fall off, and they do not need to be replaced.  Notify the office if there are any openings in the incision.
 

You should notify the office promptly if:

- You have a temperature of 101 degrees or higher.
- You have yellow or green drainage from your incision or more than a slight amount of bloody drainage.
- You have redness, swelling, or warmth around your incision.
- You have new or unusual pain, numbness, or tingling.
- You have any bowel or bladder changes.
- You have shortness of breath or chest pain.
- You have calf pain or pressure in legs.

Physical Activities

Walking: Initially, walking will be your best form of exercise to regain strength and endurance. Begin slowly by walking inside your home. Gradually increase the distance and number of times per day that you walk. If soreness or pain develop, decrease slightly the amount of walking until you are more comfortable. Do not stop walking. Walk outside, as weather permits, or use local shopping malls or schools.
Sitting: You may increase your sitting time as tolerated. Use fatigue as a reminder to rest. If you are working in this position, raise your work surface.
 

Remember to practice good posture:

- Sit up straight with hips and knees level.
- Keep neck and back in as straight a line as possible.
- Sit in a firm chair with arm rests to help with posture and assist in getting up.

Bending: All bending must be done with a straight back and bent knees. Bend slowly and carefully with something to hold onto if possible. Get a "reacher" to pick things up off the floor. Squatting down to pick things up will quickly tire you out. Don’t hesitate to ask someone for help during this important healing phase.
 
Lifting: Limit your lifting to light household items, weighing 5 pounds or less. Ideally, lifting should be limited to items at waist level, not items on the floor or in overhead places. After lifting, carry objects close to your body. As stated above, do not hesitate to ask for help when needed.

Standing: You may increase your standing time as tolerated. Use fatigue as a reminder to rest.Remember to practice good posture.

Steps: Limit steps to just a few initially, using a hand rail or support. Gradually increase steps as tolerated. Driving: Do not drive during your first two weeks at home. You may be a passenger during this time for short trips of 15 to 30 minutes. As your sitting tolerance increases, be certain to limit car riding to 45 minutes at a time, then get out of the car and walk for a few minutes. Use a support cushion in the small of your back as needed.

Lying down: You may feel most comfortable using a small pillow under your head or neck when in bed.  A recliner may also be comfortable for resting.

Sexual Activities: You may resume sexual activities as your symptoms allow.

Twisting: Avoid twisting activities such as raking, sweeping and vacuuming.

Bracing
If your physician has recommended a brace, remember to wear it as instructed.  Your physician will discuss gradually stopping the use of your brace about six to twelve weeks after surgery.  Don't stop using your brace until instructed by your physician.

Medication
In general, we recommend medication be limited to non-addictive types, such as Tylenol, aspirin or Advil.  On occasion, stronger medication is needed.  Prescription pain medication will be provided for a short time, and will be carefully monitored to guard against overuse and addiction.  Non-addicting medication will be recommended as soon as possible.

There are substances in the brain called endorphins which are similar to morphine.  Endorphins help increase our tolerance to pain.  When prescription pain medications are used, the brain slows down production of endorphins.  For this reason, it is important to use prescription pain medication for only a short period of time.  This will minimize their interference with the body's natural pain relievers.

Reminder: Do not take pain medication with alcoholic beverages.
 
Diet
Avoid straining to have a bowel movement.  You may use Milk of Magnesia or stool softeners as directed.  Include fresh fruit, vegetables, and bran cereal in your diet.  Drink six to eight glasses of water or juice per day.
 
Summary
The symptoms you had before surgery may take weeks or months to improve.  Be patient and allow your body time to heal.  Please do not hesitate to share any of your concerns with your doctor or one of his assistants.
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If you have any questions regarding medications or other relative concern please contact us.

Questions?

(651) 430-3800 or (800) 353-7720