Pre and Post Operative Care
Before Your Surgery
If you decide to have surgery, you can help make it a success by preparing for it mentally and physically. This preparation includes planning ahead for your surgery, having realistic expectations about what surgery can do for you, and following your doctor’s preoperative instructions.
Plan Ahead for your recovery, which will help reduce any inconvenience, stress, or strain. Talk to your doctor about how much time you’ll need to be away from work. You may not be able to drive or do strenuous activity for a few weeks, so arrange for friends and family to help you with errands and household chores.
Having Realistic Expectations may be the key to your successful recovery. It is important for you to understand what this procedure can and can’t do for your particular problem. Discuss your expectations with your doctor.
Pre-operative Considerations may include your making a blood donation prior to surgery. Your doctor may ask you to avoid aspirin, anti-inflammatories, or other medications before surgery. A pre-operative evaluation by your medical doctor may be required, and if necessary, a pre-operative psychological evaluation may be requested. STOP SMOKING because this negatively affects bone fusion. A brace may be recommended, depending on your problem. A spinal brace or cervical collar may be fitted before surgery or immediately after surgery. Your doctor will discuss these options with you.
In Preparation for the Surgery, you may be directed not to eat or drink anything after midnight the night before. At the hospital, you’ll be asked to sign a surgery consent form. The anesthesiologist or nurse anesthetist will talk to you about the general anesthetic you will receive.
After Your Surgery
In the hospital, overnight stay is required after some procedures (the total duration of your stay is dependent upon the severity of the operative procedure). Your stay is important so that your doctor can help control your pain and be sure your spine heals properly. Immediately after surgery, you’ll be monitored in the recovery room for a couple of hours, and then moved to your hospital room. (If you have medical problems or have a major surgery, you may be watched in the intensive care unit.) After waking from the anesthesia, you may be wearing a neck or back brace and a drainage tube may be placed in your incision. The tube will be removed in a couple of days. To protect your spine, your doctor may instruct you to wear your brace all day, even when sleeping and showering. A nurse or physical therapist will teach you how to turn, and get out of bed safely. You’ll probably get on your feet within the first 24 hours.
Pain after surgery is normal. Even simple movements can cause pain at first. You’ll be given medication and possibly ice packs to reduce pain. You may be able to control your own pain medication through your IV (intravenous feeding line). You’ll need less medication and have less pain if you take your medication before the pain becomes severe. Moving carefully also helps control pain.
At home, you’ll gradually be able to resume your daily activities; however, you’ll need to avoid anything that could injure your spine. Do not drive, lift heavy objects, or return to work without your doctor’s approval. To help support your spine as it heals, you may use a brace for as long as three months. Depending on your doctor’s instructions, you may wear it 24 hours a day, or you may be permitted to take it off during the day for short periods. Help reduce stress on your spine by practicing good posture when you walk and sit. Begin walking as soon as you get home, and then ease into specified exercises when your doctor and physical therapist say you can.
During your first few weeks you may expect to feel weak and tired, but each day should bring you increased strength. You’ll probably be sore around the incision. You may still have some pain, tingling, or numbness in your back or legs. This should decrease gradually as the nerves heal. Keep moving as much as you can without causing increased pain.
By about the sixth week, your back should be well on its way to healing. If you’re using correct posture and movements and exercising regularly, you should feel better and be able to do more each week. Continue to let pain be a warning to slow down.
Walking is the best exercise following spine surgery. It strengthens your back and leg muscles and increases your endurance. It also relieves stress, which can cause the muscles in your back and neck to tighten. Begin walking around the house. Build up to taking several walks a day. Brace your abdominal muscles and take medium strides.
Follow-up Care If your incision is closed with nonabsorbable sutures or staples, your doctor will remove them a few days after your surgery. Your doctor will schedule follow-up visits to make sure your recovery is successful. If you had fusion, x-rays may be taken to see how well your graft is healing. The graft should be almost completely healed in about three months. If you had arm or hand pain, numbness, or weakness prior to surgery, your doctor may also evaluate nerve function and arm strength.
Successful Recovery requires that you approach the surgery and recovery period with confidence based on a thorough understanding of the process. Your surgeon has the training and expertise to correct physical defects by performing the operation; he and the rest of the health care team will support your recovery. Your body is able to heal the involved muscle, nerve, and bone tissues. Full recovery, however, will also depend on you having a strong, positive attitude, setting small goals for improvement and working steadily to accomplish each goal. Surgery may not make your spine just like new, but it can help relieve pain and let you get back to most, if not all, of the activities you enjoy. How well your spine recovers depends on the time and energy you put into protecting and strengthening your spine – now and for the rest of your life. Maintaining good posture, moving safely, and exercising regularly are the best care you can give your back. Think of them as daily investments. They’ll pay you back in less pain and more pleasure.