Post-Operative Care for Back Surgery in Dallas
The information below consists of generalizations and is appropriate for the vast majority of back patients, but each patient will have an individualized plan that the patient will create with his or her spine surgeon. The following is general information for all spine surgeries, followed by information for specific surgeries.
For the first few weeks after spine surgery, the sharp cutting pain from back surgery will subside, but most people will feel sore and have decreased endurance beyond that for a while longer. Over the first few weeks it is expected that back pain patients will wean off any narcotic (pain) medication. We will only be able to refill pain medications in the clinic, so it is important for spine patients to plan accordingly. We cannot refill pain medications or other medications over the phone after hours or on the weekend. If you need a refill or back pain medicine, it is recommended that you call the clinic for an appointment at least three business days before you would run out.
Patients should resume their normal diet once at home but should also add fiber, either through fiber supplements or food, like prune juice, to prevent constipation. Also, taking over-the-counter stool softeners, and laxatives if needed, is recommended after a spine surgery. It is much better and easier to prevent constipation than to treat it; the medications for constipation are over the counter, and a prescription is not required. The local pharmacist can provide guidance for these medications after a spine surgery in Dallas.
Patients should shower daily once at home, unless instructed differently from their spine surgeon. For cervical surgeries, remove your collar and shower normally. Typically, you will shower with your bandage on, and then have someone remove your bandage after showering, dry the area well and gently and place a new bandage. The bandages for lumbar surgeries, both front and back, are more of a cushion or pad to prevent pants from rubbing the incision. Rubbing the surgery incision will cause irritation, and that could lead to infection. The bandage does not need to look like what was used in the hospital—oftentimes gauze and tape is just fine.
Follow-up appointments are usually three weeks, two months and six months after surgery. Fusion surgeries are usually seen at the year anniversary of the spine surgery, and large spinal reconstructions are generally followed yearly for a few years. Obviously, if there are issues or questions that arise, patients are asked to contact the clinic to arrange follow up sooner.
Spinal patients should avoid bending, lifting and twisting for the first eight to 12 weeks; after that time, they are started in outpatient physical therapy to work on core strengthening. Before that time, the only core rehabilitation is to work up to walking 30 minutes or more a day. Sometimes home physical therapy or even outpatient therapy is used to help with daily activities and improving walking and transitioning; this is determined by the physical therapists while the patient is in the hospital. Once outpatient core strengthening physical therapy is completed, spine surgery patients can slowly resume their normal activities.
Lumbar surgery patients should avoid bending, lifting and twisting for the first six weeks; after that time, they are started in outpatient physical therapy to work on core strengthening. Before that time, the only core rehabilitation is to work up to walking 30 minutes or more a day. Rarely, home physical therapy or even outpatient therapy is used to help with daily activities and improving walking and transitioning after spine surgery. This is determined by the physical therapists while the patient is in the hospital. Once outpatient core strengthening physical therapy is completed, patients can slowly resume their normal activities.
After ACDF, for the first six weeks, spine surgery patients are asked to wear a cervical collar at all times, except showering. After six weeks, the collar use is stopped, and physical therapy is started. Prior to that time, back patients should work up to walking 30 minutes or more a day. Generally, all non-strenuous activity is allowed while wearing the collar. Everyone will experience a certain degree of swallowing difficulty and hoarseness; this can last for a few days or weeks. This occurs because the trachea and esophagus are retracted out of the way to protect them during surgery; these structures are responsible for speech and swallowing respectively. Once outpatient cervical physical therapy is completed, spine surgery patients can slowly resume their normal activities.
Spine surgery patients are asked to wear a cervical collar after laminoplasty surgery for three to four weeks. This allows the posterior extensor muscles to heal and begin functioning again to prevent cervical kyphosis. The collar can be removed for showering and when lying down flat; the collar is to prevent gravity from pulling the head into a forward or kyphotic position. Once the collar use is stopped, physical therapy is started to strengthen the extensor muscles of the neck and gain flexibility. Once outpatient cervical physical therapy is completed, patients who had spine surgery can slowly resume their normal activities.