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If you have had problems with your back that just refuse to go away, you might be a good candidate for spinal surgery. Keep in mind that an invasive surgery like this will only happen after your doctor has tried other remedies first, such as extensive physical therapy, medications, and other procedures that might bring relief.
For some, alternative methods work for a while but stop helping when the spinal problem gets worse. And for others, other treatment options just aren’t enough. That’s when surgery comes into play.
What to expect after spinal surgery depends on many factors. Some surgeries on the spine are very simple and straightforward, such as replacing a herniated disc. This might require a very small incision and little healing time; you will probably feel much better than you did before even in the first days after the surgery.
Other surgeries, such as spinal fusion, are more invasive and could require a much longer recovery time. Spinal fusion is exactly what it sounds like: your doctor fuses vertebrae in your spine together with bone grafts or metal hardware. Medline Plus offers a look at the different types of spinal surgery that are most common in the United States.1
According to Frontiers in Pain Research, about 500,000 people undergo lumbar spine surgery every year in the U.S. The success rate of this procedure is very high and it’s considered to be quite safe.2
But much of that success rate depends upon how well you adhere to the recovery schedule after the surgery. Once the doctor has done their part to fix the issue, it’s your responsibility to follow every recommendation during your recovery.
So let’s take a dive into what to expect after surgery.
Remember that this is a rough outline. Your recovery depends greatly upon the type of surgery you had, underlying medical conditions, any complications you might experience during surgery or after, and any sort of hardware that was inserted around or in your spine during the procedure.
Before the Surgery
You will be given very clear instructions on how to prepare for surgery. According to Johns Hopkins Medicine, this can include everything from stopping smoking to not taking certain medications. Get any chronic conditions well under control before the big day. You will also need to make plans for someone to help you after the surgery, as you will be “out of commission” in regard to household tasks, driving, and more.3
Be sure to ask any questions about the surgery well in advance. Write down your questions and answers so you can refer back to them after the surgery, if needed. When the day of the surgery arrives, things might move very quickly, and you might not be able to remember your questions or even have time to ask them. Make sure you are fully informed well before the day comes.
When You Wake Up After Surgery
Waking up after any surgery can be disorienting. Not only is your body full of anesthesia drugs that can affect your mental capacity, you are in a strange place, probably surrounded by strange people. Feeling scared or anxious is normal.
What you shouldn’t feel, however, is pain. You will be on heavy pain medication. If you are in pain at all, tell someone right away.
You’ll start to realize other things as you slowly wake up. A nurse will be watching you closely. You might have a tube in your back to drain fluid from the surgical site, an IV (or two) in your arm to deliver pain meds and antibiotics, a catheter in your urethra that drains urine so you don’t have to get up to go to the bathroom, and maybe even all sorts of wires attached to your skin with sticky pads to monitor your heart, lungs, and more.
You might also notice a strange sensation around your legs. These are compression sleeves, which will squeeze your calves to keep the blood moving and prevent blood clots.
The First 48 Hours
During this time, you will be very closely monitored in your hospital room. You will still be tired and groggy, but more alert with each passing hour as the anesthesia wears off. You will likely have a pain pump, which is a small device that delivers pain medication on demand. When you need it, press the button, and the medication will flow through your IV.
You will meet with a respiratory therapist who will teach you how to do breathing exercises to keep your lungs clear. You will also meet with a physical therapist, an occupational therapist, a hospital social worker, and many others who are part of your aftercare team.
You might start physical therapy after 24 hours. However, if you’ve had a more complex spinal surgery, you might not be expected to move at all for a few days.
The First Week
You might be in the hospital for anywhere from a day to a week, assuming there are no complications after the surgery.
During that time, you will learn quite a bit. Physical therapy will begin, and getting up out of bed to move around becomes a priority. You will learn range-of-motion exercises that strengthen your arms and legs. You’ll be watched closely to make sure you can move properly.
If you have a back brace, you’ll learn how to take it off and put it back on. You and your caregiver will be coached on wound care. You will learn to transfer from the bed to a wheelchair and you will be taught the proper way to use a walker.
Your pain should always be well-controlled. However, there might be times, especially during PT, when it seems like the pain relief isn’t working as well. This is normal. Rest will help you get back to equilibrium.
Home From the Hospital
It’s normal to be very nervous when you’re sent home from the hospital. But rest assured that you will have plenty of pain medication, antibiotics, and other necessities with you.
You will continue to have physical therapy. They might come to you, or you might be required to come back to the hospital or an outpatient clinic. The main exercise is walking, which helps you heal faster. But other exercises are common too, including those that will gradually help you regain range of motion in your back.
You still need a great deal of rest. You will need a family or professional caregiver to provide wound care, as reaching the incision site yourself will be almost impossible.
Controlling Your Pain
This is a big worry for anyone after surgery. And it makes sense; in the initial weeks after surgery, up to 80% of people experience discomfort or pain as a result of their spinal surgery.4
With the proper rest and recovery care, many are surprised by how quickly their pain diminishes and how soon they can stop taking the narcotic pain medication. However, don’t try to be a hero – if you need the meds, take them!
Even if you don’t feel as though you need them anymore, take the prescription drugs at least 45 minutes before a physical therapy session to preemptively deal with the resulting pain. Don’t take nonsteroidal anti-inflammatory drugs, like Aleve or Motrin; they can slow healing.
Remember that narcotic pain medication slows down the digestive tract, which can lead to serious constipation. Talk to your doctor about stool softeners and laxatives.
Sitting and Sleeping
You might want to set aside that easy chair for a while. The best chair for recovery is a sturdy one with strong arms and a straight back. This helps you keep the best posture. When you change positions, don’t twist your spine. Instead, use your arms to push yourself up, shift a little, and then sit back down.
But don’t sit for long. Thirty minutes is the maximum you should be spending in a chair. You need to keep moving to help blood circulate through your body.
When you sleep, of course you will be motionless for a while. Make sure you use the proper sleep positioning, as directed by your physical therapist. You will need a lot of pillows to get into a comfortable position. When you get out of bed, do so with a “log” roll. This means you will bend your knees, roll to your side, and push yourself up with your arms, keeping your back straight.
Naps are very good things. Take lots of them during recovery.
Caring for the Incision
This part will be tough to do on your own. You’ll need a family caregiver or a home health aide to handle this for you. You might need to go back to the hospital every few days for checks of the incision, especially if it’s substantial. The tube (if you have one) will remain in place for a week or two, and any stitches or staples will remain for two weeks or so. If your incision is closed with “skin glue” you might not have to worry about stitches or staples at all.
If there is every any sign of redness, serious inflammation, or infection, talk to the doctor right away.
Personal Hygiene
It might be a few days before you are allowed to shower. Once you are allowed to do so, use a shower seat or stool for added safety, and wear a showerproof medical alarm to be safe.
If you have a walk-in tub, now is not the time to use it. The doctors will want your incision to stay as dry as possible. Get the green light from your doctor before you enjoy a long soak again.
Look into aging in place home modifications, such as a raised toilet seat that makes it easier to use the bathroom on your own, grab bars to help ensure you stay upright, and bed rails to provide peace of mind.
Home Safety
We do quite a few things at home that we take for granted until we can’t do them anymore. For instance, you will likely be instructed not to lift anything heavier than a gallon of milk. That means picking up the grandkids is off-limits! You might not be able to carry a laundry basket or even do laundry if it means too much bending and stooping.
Be kind to yourself. Hire a housekeeping service and a lawn care professional while you are on the mend. Rely on family and friends to help you with the little necessities, such as getting that casserole dish from a high shelf or carrying the laundry up the stairs. Especially if you live alone, consider an alert for elderly adults that will give you the opportunity to call for help at the touch of a button. For many seniors, this medical alert technology is an incredibly valuable companion, ensuring you are never really alone.
Driving and Getting Out
Driving is probably a no-go for at least three weeks. That’s not only because the act of driving requires twisting your spine to look at mirrors and blind spots, but also because you shouldn’t be behind the wheel of a car while you take narcotic medications. Get your doctor’s explicit approval before you start driving again.
Remember that it might take two or three months (or longer) to recover from spinal surgery. And during that time, you will need plenty of rest and sleep – don’t plan any big outings or events during the time you are recovering. You might be surprised by how tired you are through the process. It’s okay to give in to it. Regular naps and a solid night’s sleep will help you recover much faster.
Following Up
You will go to physical or occupational therapy at least a few times a week for a month, perhaps more. Your doctor will want to see you about six weeks after the operation to ensure that you’re doing well. You can expect more X-rays, MRIs, and other imaging tests to make sure the surgery went as it should and there are no barriers to healing.
You might have to see the doctor every few months to track your progress and make sure all is well.
Always wear an emergency button alert device as you go about your life following spinal surgery. Though your spine is tough – and even tougher once you have hardware in it – you can still suffer devastating consequences if you fall down or suffer any other sort of accident. Having a way to reach out for live help right away, 24/7, helps keep you as safe and healthy as possible on the road to recovery and beyond.