Complex Spine Surgery

Recovery

As you prepare for your surgery, it is important to be proactive. Before the surgery you should make sure that you understand what the surgery entails and also what to expect in the weeks and months to follow. It is equally important to learn how to play an active role in your care to ensure a smooth and speedy recovery. To help you with your home recovery, your surgical team will give you some instructions to follow. If unsure you should ask for clarifications and follow these instructions closely and diligently.

Hospital Recovery

After the surgery, you will wake up from the anesthesia in a recovery room or intensive care unit (ICU) and may feel slightly disoriented. The nurses and doctors around you will tell you that you have undergone surgery. You will feel very tired at this moment and so the nurses and doctors will encourage you to rest for some more time.

Once the effects of the anesthesia wears off completely, you will be awake and find yourself lying on your back. Members of your surgical team will come and ask you to respond to some simple orders, such as “Wiggle your fingers and toes” or “Take deep breaths” to check that you are all fine.

In addition to the intravenous (IV) tube in your arm that was inserted before the surgery for providing fluids to your body during your hospital stay, you may now also have a catheter tube (Foley Catheter) placed into your bladder to drain urine from your body. The catheter eliminates the need for you to get up and go to the bathroom and also helps the doctors and nurses to monitor how much urine your body is producing. The catheter will be removed when you are able to get up and can use the bathroom normally.

After the surgery, you will continue to receive fluids through the IV inserted in your arm until you are able to tolerate regular liquids. Your diet will then be gradually changed from clear fluids to full liquids (including gelatin) and to small amounts of solid food until you are ready to return to a regular diet. As proper nutrition is very crucial for your body to restore the damaged tissues and return to normal, your surgeon may either restrict what you drink and eat, or place you on a special diet.

Regarding the physical activity, with most spinal surgeries it is no longer recommended that you lie in bed for weeks after spine surgery. In most cases, your surgeon will ask you to get out of bed on the first or second day itself after your surgery. Initially, in your first few “trips” out of bed, nurses and physical therapists will assist you with this activity until you feel comfortable enough to get up and move around on your own.

Home recovery

After staying in the hospital for a few days, you will be discharged to home.
Before that, your doctor will make sure that you have normal vital signs and bladder function, you can eat without feeling nauseated and there are no signs of infection at the incision site.
Your doctor and other members of the hospital staff will also give you some self-care instructions for you to follow at home that are crucial to your recovery. These are a list of “dos and don’ts,” which you will be asked to follow for the first 6 to 8 weeks of your home recovery. These may include the following:

  • Avoid sitting and standing for longer than 20 to 30 minutes at one time and try to change positions frequently to avoid muscle spasms and leg cramps.
  • Get plenty of rest.
  • Abstain from smoking as nicotine slows bone healing.
  • Good nutrition is essential for a successful recovery. Eat a healthy diet, high in protein and rich in fresh fruits and vegetables and drink plenty of fluids. Avoid heavy, fattening foods and foods that are high in calories.
  • Short walks for the first few weeks after the spinal surgery are encouraged. Walking is a low impact exercise that builds strength and maintains muscle tone. The distance you walk can be gradually increased. Deep-breathing exercises are also helpful.
  • Avoid carrying or lifting anything heavier than 10 pounds.
  • Avoid bending at the waist. Rather, bend at your knees to pick up things. Also avoid twisting the back.
  • Totally avoid driving the car for the first few weeks after your surgery. You can ride in the car only for short distances during this time. Later, if your doctor permits you may take short trips when necessary.
  • Avoid any strenuous activities. Even avoid vacuuming and more strenuous household cleaning. Do not go for swimming, golfing, and running or participate in any other sports activity until your doctor permits.
  • Keeping the incision dry for first 5 – 7 days is important. Avoid taking showers until your doctor permits you to do so. Also avoid applying any skin lotion on the incision area.

Wound care

When you will be discharged, you will still have a surgical dressing on your incision(s). At home, the dressing should be kept dry and should be changed daily. Either a caregiver, such as one of your family members (once taught by the nurse) can change the dressing for you or a nurse may be scheduled for home visits to do it. Moreover, while changing the dressing if any of the following signs of infection are observed, you should call your doctor immediately:

  • Fever higher than 101°F
  • More redness or swelling around the incision(s)
  • Extra fluid drainage from the incision(s)
  • Incision has open areas along its length

You should also call your doctor if you experience chills, nausea/vomiting, or suffer any type of trauma such as a fall or a car accident. Difficulty in urinating or controlling your bowel movements is a medical emergency and in such a situation you should contact your doctor immediately.

Call your doctor if you have any worries or questions.