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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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