The type of surgery you have will determine how long you will need to stay in the hospital and the type of post surgical care you will need. Many neck / back procedures require one to three nights in the hospital.
What Can I Expect While in the Hospital?
Immediately following your surgery, the nursing staff will begin monitoring your condition. As the anesthesia begins to wear off, you will be moved to a hospital room until you are ready to go home.
The day following surgery. A number of surgeries require that you wear a brace afterward. If this is the case, keep your brace on until your surgeon specifically instructs you to remove it. With assistance if needed, you may be encouraged to stand and sit within the first 24 hours after surgery. Under the supervision of a physical therapist, you will sit on the edge of the bed and stand with support. Walking will be approached gradually and carefully to avoid injury and complications. It is important to not over do it the first few times you get up and walk.
Treatments: The circulation and motion of your legs and feet will be checked. The dressing on your incision may be removed and changed. In some cases, an ice pack or cooling pad may be used to help decrease swelling and increase your comfort. It is common to continue IV use for the first day or two.
Medications: To help prevent infection, antibiotics may be injected via IV in the first 24 hours. Pain medication will be made available as needed to help alleviate any pain or discomfort. In most cases, you will most likely be given pain medications that are injected into your IV line or directly into your arm or buttock. These medications are usually much stronger and faster acting than pills taken by mouth. As it is important to keep your pain in check so you can participate in your rehabilitation program.
Diet: The affects of anesthesia vary from patient to patient. As your intestinal function returns to normal, you will be allowed to have clear liquids as soon as you are able to eat. If your stomach agrees to clear liquids, you will be given food that is more solid.
Activities: Early on, your physical therapist will work with you to begin moving safely in bed and up to a sitting position. Gradually, you will progress to standing and walking. For a short time you may require the use of a walking aid. Exercises may be suggested to relieve soreness in your legs and help prevent blood clots.
Tests: If your doctor has placed you on blood thinning medications, you may need to have your blood checked every day.
By your second day in the hospital after spine surgery, you may expect the following:
Treatments: Your IV line and urinary catheter (if applicable) may be removed. Your wound dressing may be changed or removed.
Medications: It is natural to feel a little pain during the first few days after spine surgery. By the 2nd day, you will most likely transition from pain medication through IV to oral pain medication. When you are ready to go home, oral medications will make things easier.
Activities: It is crucial to continue doing the exercises that have been prescribed by your doctor or PT to help improve motion and keep your muscles from getting sore and tight. Ice packs may be applied before and after therapy treatments to reduce swelling and relieve pain. With assistance from your PT, you will gradually increase the distance you are walking in preparation for going home.
Day 3 and Beyond:
Treatments: Your incision dressing will be changed if needed or removed.
Activities: With the objective of enabling you to be independent, your physical therapy will continue to focus on safety with mobility. Even though you may experience mild discomfort, it is important that you do your deep breathing and exercises as instructed. When your doctor feels that your medical condition is stable, you will be able to return home. In order to give your body a chance to heal, you may be instructed to limit your activities for a period of time.
What Can I Expect When I Get Home?
After neck / back surgery, people often feel better soon after they awake from the surgery. Participating in a comprehensive rehabilitation program will fulfill the maximum benefits of surgery. 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 get smaller, decreasing the blood flow. This helps control inflammation, muscle spasm, and pain. Heat may also be recommended. Heat makes blood vessels get larger, increasing the blood flow. This helps flush away chemicals that cause pain. It also helps bring in healing nutrients and oxygen.
Relaxation: The pain following surgery can be physically and emotionally draining. Relaxation exercises may help you control pain and the stress that comes with it. You may be given instructions for breathing exercises to help air reach deep into your lungs. Additionally, you may 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: Allowing your body to rest can help ease soreness after surgery and give your spine time to heal. Follow your doctor's instructions for using any prescribed supports or braces.
Positioning: Certain positions may be suggested to give your spine optimal comfort. These positions may include the use of pillows or towels to support your spine and help alleviate pressure from the surgical area.
Movement: Using safe body movements may help you avoid extra strain on your spine in the weeks after your spine surgery.
Lying in Bed: It is important to avoid lying in positions that twist or angle your spine. 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: To get out of bed, roll onto your side and sit up while keeping your spine steady and secure. Avoid twisting your upper body when you roll to one side, instead roll your whole body as a unit, similar to rolling a log. Next, allow your legs to ease off the edge of the bed toward the floor as you push yourself up into a sitting position. This will reduce 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: Maintain an upright spine when sitting. A safe, upright posture reduces strain on your spine. Select a chair that supports your spine. Pass on soft couches or chairs. Position a cushion or pillow behind your back while driving or riding in a car. When standing, keep your spine aligned by leaning forward at the hips.
Bending: You may be instructed by your physician or PT to not bend for a few weeks after spine surgery. Always follow your doctor's instructions. When you are able to bend, do it safely. Keep your back straight and secure as you bend forward, making sure your spine is straight.
Lifting: You may also be instructed to not lift or carry anything for a period of time after surgery. Do lift or carry anything until your doctor says 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. Consult your doctor or PT if you have any questions about the safety of lifting or carrying.
Outpatient Therapy: Outpatient rehabilitation may be prescribed 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 physical therapist will teach you ways to help reduce your pain now, and help you develop new habits to keep your spine healthy.