Spine surgery is a major decision for people. Patients are concerned not only about the procedure but also about the recovery period following spinal surgery. In this blog We have summarised the normal post-operative treatment of a patient following spine surgery.
Wound care and bath:
It is normal practice to change dressings often, even if they are clean. Patients sometimes ask the doctor how often they should change their dressing. A dressing change is typically not necessary following minimally invasive spine procedures unless the dressing material becomes soaked in blood/liquid/body fluids (sweat, urine, or faeces). A dressing change is typically performed before hospital release for larger/open surgeries.
A drain is implanted for larger procedures or surgeries that result in considerable bleeding. Draining helps to eliminate extra blood from a surgical site. This extra blood might normally gather inside the wound, becoming a source of infection, or seeping through the wound, delaying wound healing. In these circumstances, the dressing is changed immediately after surgery, and the drain is removed.
Patients at home do not need to change their dressings until they become moist or come off the skin. It is usually removed at the same time as the suture/staples after two weeks. A temporary bandage may be placed following suture removal for a few days to allow the suture removal holes to heal. Many patients have absorbable sutures. These people do not need any stitches removed. Small stereo-strip dressings may be left around the wound, which will fall off spontaneously after taking a bath in a few days.
Patients can take a mild shower 4-5 days following surgery. To avoid infection, it is best not to use water-based soap on the wound. Wiping the body down with a moist cloth is another option. Water-repellent dressings that cling to the skin serve to keep the wound dry.
Infections, though rare, can occur. A heated, red, and swollen wound suggests infection, especially if there is frequent, foul-smelling discharge accompanied by fever and chills. In this case, your surgeon should be notified promptly.
Mobilisation:
In most situations, patients may sit and walk the same day or the next following spine surgery. Usually, there are no restrictions on how long a patient can sit, stand, or walk. Patients are free to participate in these activities at their discretion. This is true even for open operations. Robust titanium implants enable quick weight bearing following spinal instrumentation operations.
Patients who have pre-operative leg weakness may need to wait until leg strength recovers before walking again. However, even in these circumstances, sitting is permitted immediately. Implant hold is insufficient in severely osteoporotic bones. To avoid implant loosening/breakage, these patients may need to stay in bed for an extended period until spinal fusion occurs.
Household work:
Patients are allowed to conduct domestic chores in a sitting or standing position as soon as they are comfortable. They are normally free to sit, stand, or stroll for as long as they like. However, leaning forward, sitting on the floor, and heavy lifting should be avoided.
Other Activities:
Patients are free to carry out all activities in chair-sitting or standing positions that are most comfortable for them. Walking-related activities are also permitted, such as visits to the local market or walks in the park. The patient can also climb stairs. It is suggested to avoid the following activities:
- Sitting on the floor
- Bending forward
- Lifting hefty loads (more than 5 kilogrammes).
- Twist the body
These limits are often enforced for 4-6 weeks to allow the disc and soft tissue near the surgery site to recover. Additionally, bone repair and consolidation take around 3-6 months after spinal fusion surgery. High labour, carrying extremely high weights, and sporting activities should be avoided for 6 months following fusion surgery. These limits are in place to avoid symptom recurrence after spinal decompression surgery and implant failure (loosening/breakage) following spine fusion surgery.
Return to Work:
Patients who work at a desk or in an office can start as soon as they feel comfortable. People who travel often or engage in mild-moderate demanding occupations should wait 3-4 weeks after a decompression operation and 6-8 weeks after a spine fusion surgery before returning to work. Heavy manual labour should be avoided for three to six months.
Use of braces:
A cervical or lumbar belt is typically used to stabilise the spine following surgery. These braces provide some spine support, but their major goal is to control spine motions, soothe the patient, and remind them about the operation so they continue to take usual precautions.
Physiotherapy:
The patient needs some assistance to sit and walk soon following surgery. Physiotherapy is offered while they are in the hospital. Once released, the majority of patients do not require further physiotherapy. They are encouraged to engage in activities on their own. Patients with pre-operative weakness, extra weight, or other medical conditions may require a lengthier course of physiotherapy. This may be done at home as well. For individuals with leg/arm weakness, electrical muscle stimulation treatment is essential for a few weeks to assist muscle recovery.
Pain During Recovery:
Pain from spine surgery is bearable. During a hospital stay, powerful pain drugs are administered orally and intravenously. After discharge, patients are given gradually diminishing dosages of pain medication, with the expectation that discomfort will gradually subside as healing occurs. Some pain medicines are provided following suture removal and should be taken as needed.
Nerve Recovery:
Nerve compression can produce a variety of symptoms. Pain, tingling-numbness, loss of feeling, and muscular weakness typically develop in order. Severe spinal cord compression affects the intestines and bladder. Even if the spinal cord and nerves are free following surgery, healing does not occur immediately. Pain symptoms (radiculopathy) are typically the first to improve. Tingling-numbness might last for a long period. Weakness in muscles and bowel-bladder involvement requires a long time to heal since these symptoms imply severe nerve injury. Additionally, nerve healing is seldom linear. Patients typically have recurring bouts of discomfort and numbness while recuperating. They should be educated about this phenomenon to avoid concern.
Conclusion
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