When coming round from the general anaesthetic most patients will be fitted with a surgical collar, or brace to maintain the stability of the spine as healing begins. This support device will be stiff and should prevent damaging movement of the spine that could affect the fusion, if performed, or cause slippage or fracture from alterations in the spinal structure. Patients are advised against any heavy lifting, twisting, bending, and specific stretches for several weeks after surgery. Ensuring that guidelines are understood and followed will optimize recovery from back surgery. A follow-up appointment (usually two weeks after surgery) gives the patient the opportunity to discuss the resumption of activities such as driving, and exercise (including sexual activity).
Taking care of the incision
Hygiene advice should be adhered to in order to prevent infections occurring. The incision should be kept clean and dry and should not be submerged in water until fully closed. Patting the wound dry rather than rubbing is advisable and the dressing should be changed regularly. Any redness, swelling, increasing tenderness, or fluid leakage requires immediate investigation in order to prevent any potential infection becoming severe or even fatal. Fever and headaches could indicate an infection that has spread to the spinal fluid and patients are often advised to measure their temperature at the same time everyday (4pm or so) to monitor their condition.
Some pain at the incision site is normal, and spasms of the back muscles may also occur. Keeping warm and avoiding sitting for long periods can help to reduce their incidence. Patients will normally be given analgesic medication to help control pain as they recover. Narcotic medication is not usually used for any extended period of time after back surgery with NSAIDs more commonly prescribed unless spinal fusion has been performed in which case NSAIDs are contraindicated. If any over the counter medications are taken then patients should make sure not to take more than 4000mg of acetaminophen in a 24hr period and it is wise to let the doctor know of any other pills taken when prescriptions are being written.
Any numbness experienced pre-surgery is likely to continue for a time after surgery as the spine heals. It can take six to eighteen months for a damaged nerve to heal, depending on the extent of the compression. Paraesthesia and neck pain may continue during this time. Recovery can be aided by resuming gentle walking and gradually increasing activity as advised by the physician. Some activities and actions should be avoided such as raising the arms above the head if a cervical spinal laminectomy has been performed.