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BACK AND SPINE

 

Back Pain Information

Upper Back Pain

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SURGICAL PROCEDURES

 

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TREATMENT OPTIONS

 

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NON-SURGICAL TREATMENT

 

Epidural Steroid Injection

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Facet Joint Injection

Medial Branch Blocks

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PATIENT RESOURCES

 

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Before Your Surgery

After Spine Surgery

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After Your Surgery

Back surgery is usually seen as an elective procedure that is only used after conservative pain management options have proven ineffective or the patient’s symptoms have become debilitating. Generally speaking, there are two back surgery approaches that are used to alleviate symptoms stemming from nerve compression in the spine: open back surgery and endoscopic spine surgery. In both methods, the surgeon is working to alleviate the impingement and irritation of the spinal cord and/or nerve roots.

When nerve tissue in the spinal column is impinged and irritated, a patient can experience a variety of pain symptoms, known collectively as radiculopathy, including: local or radiating pain, muscle weakness, and numbness and tingling in the extremities. Most commonly, this nerve agitation is caused by a bulging or herniated disc, degenerative disc disease, spinal stenosis, foraminal stenosis, arthritis in the spine, the presence of tissue build-up, and bone spurs.

Once the diagnosis of the back or neck problem has been confirmed through a complete medical exam and imagery such as an MRI, a number of surgical options may be presented. With open back surgery, a common procedure is spinal fusion where the damaged disc is literally removed and the vertebrae above and below the removed disc are permanently welded together. Artificial disc replacement (arthroplasty) is another possibility for some patients.

Alternatively, a number of minimally invasive, outpatient orthopedic procedures have been growing steadily more popular in recent years. These procedures are performed on an outpatient basis, are less painful, and have a shorter recovery time than open-back or open-neck surgery. These laser-assisted procedures also typically do not require hospitalization, general anesthesia, or lengthy rehabilitation after the surgery.

Recovery and success rates from back surgery also are varied, depending on the patient’s pathology. Success of the back surgery is typically relative; some patients experience immediate relief and others gradual. Success of a surgery is also closely related to the completion of post-operative rehabilitation and physical therapy. It is equally important that patients go into surgery with realistic expectations.

Our surgeons perform more minimally invasive neck and spine procedures per month than any other facility. More than 85 percent of our patients have said they experienced some improvement or total pain relief within 3 months after their procedure.

What Can I Expect When I Get Home?

Most people who have spine surgery experience good to excellent results. They get significant relief of pain and the return of functional movement and strength. Most are able to walk, sit, drive a car, and perform other activities of daily life.

After spine surgery, people often report feeling better soon after they awake from the surgery. Although you may see and feel immediate benefits, you will get the maximum benefits of surgery by taking participating in a comprehensive rehabilitation program. The sooner you become active, the sooner you will get back to your normal routine. At the same time, remember to protect your healing back. Increase your activity level at a slow but steady pace.

  • Tubes to drain the incision
  • An IV to give you fluids and medication
  • A catheter (tube) to drain your bladder
  • Boots or special stockings on your legs to help prevent blood clots

Prepare Your Home for Your Return

If your movement is limited during recovery, ask a family member or friend to help prepare your home for your return by removing hazards that could cause you to trip, slip, or fall. One place in particular to prepare for your return home from the hospital is your bathroom. The tips below will help make your bathroom safer and more comfortable while you heal. Keep in mind that some of the equipment listed will need to be ordered so it is ready for when you get home

Bathroom Safety Tips

  • Prevent slips and falls by using non-slip surfaces in your bathroom
  • Consider putting in grab bars and railings for support
  • Watch out for hazards, such as wet floors
  • Talk with your occupational therapist if you need more instructions in using bath aids
  • Install a hand-held shower hose
  • Use a long-handled sponge to wash hard-to-reach areas
  • Use a non-slip bath mat to help keep the floor dry
  • Use grab bars in your shower or tub for support as you get in and out
  • Sit on a bath bench or shower chair while you bathe

If you had surgery that limits bending, use a commode chair or elevated toilet seat to raise the height of your toilet

Things You Can Do At Home to Help Yourself Get Better

When you are leaving the hospital, your doctor or PT may recommend some or all of the following to help you get better at home:

  • Ice and Heat—cold treatments are usually recommended in the first few days after surgery. Ice makes blood vessels vasoconstrict (vase-oh-con-strict) (get smaller), decreasing the blood flow. This helps control inflammation, muscle spasm, and pain. Heat may also be recommended. Heat makes blood vessels vasodilate (vase-oh-dye-late) (get larger), increasing the blood flow. This helps flush away chemicals that cause pain. It also helps bring in healing nutrients and oxygen.
  • Relaxation—pain after spine surgery can be physically and emotionally draining. Relaxation exercises can help you control pain and the stress that comes with it. You may be given instructions for breathing exercises to help air reach even deep into your lungs. You may also be instructed to slow your breathing to a more relaxed pace. Slower breathing can help muscles relax, while bringing much needed oxygen to sore tissues.
  • Rest—giving your body a chance to rest can help ease soreness after surgery, giving your spine time to heal. Follow your doctor's instructions for using any prescribed supports or braces.
  • Positioning—your PT may suggest ways to position your spine for the greater comfort. These positions may include the use of pillows or towels to support your spine and help take pressure of the surgical area.
  • Movement—careful movements suggested by your PT can safely ease pain by providing nutrition and lubrication in the areas close to the surgical area. Movement of joints and muscles also signals the nervous system to block incoming pain. Using safe body movements can help you avoid extra strain on your spine in the weeks after your spine surgery.
  • Lying in Bed—avoid lying in positions that twist or angle your spine. Do not curl up in the "fetal" position. Choose a firm mattress. Do not lay on a soft bed or sofa. Keep enough pillows nearby to support your head, shoulders, trunk, and legs.
  • Moving in Bed—when getting in or out of bed, use the "log roll" technique. To get out of bed, roll onto your side and sit up while keeping your spine steady and secure. Instead of twisting your upper body when you roll to one side, try to roll your whole body as a unit, like rolling a log. Then let your legs ease off the edge of the bed toward the floor as you push yourself up into a sitting position. This reduces strain from twisting your spine and gives the surgical area time to heal. To get into bed, do just the opposite: sit first with your legs hanging off the side of bed, then lie on your side and roll like a log onto your back.
  • Sitting—keep your spine upright and supported when sitting. A safe, upright posture reduces strain on your spine. Choose a chair that supports your spine. Avoid soft couches or chairs. Place a cushion or pillow behind your back while driving or riding in a car. When standing up, keep your spine aligned by leaning forward at the hips.
  • Bending—your doctor or PT may tell you not to bend for a few weeks after spine surgery. Always follow your doctor's instructions. If and when you are given the okay to bend, do so safely. Keep your back straight and secure as you bend forward, making sure your spine is straight. Consider using a "grabber" to avoid bending over at the waist to put on socks or shoes, and to pick up items from the floor.
  • Lifting—your doctor may tell you not to lift or carry anything for a period of time after surgery. Do not test your back by trying to lift or carry anything until your doctor says told it is okay. If you must pick up or carry lighter items, squat down by bending your knees. Do not lean forward by bending your spine forward. Keep the item close to your body, even if it is light. Holding the weight out in front of you puts extra strain on your spine. Check with your doctor or PT if you have any questions about the safety of lifting or carrying.
  • Outpatient Therapy—your doctor may prescribe outpatient rehabilitation once your condition has begun to stabilize. Your recovery from spine surgery can be improved by learning new ways to strengthen your spine and prevent future problems. Your PT will teach you ways to help reduce your pain now, and help you develop new habits to keep your spine healthy.

 

   

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