Frequently Asked Questions About Spinal Surgery
Here are some facts and procedures about spine surgery and rehabilitation. While some procedures may vary from hospital to hospital, these are the most common practices.
1. Why should I get spinal surgery?
The spine acts as the main foundation of your body, enabling you to sit, stand, walk, run and do others of simple and basic movements. Aside from that, the spine also houses and protects your spinal cord, the main thoroughfare of your nervous system. It is responsible for delivering and sending sensations and instructions to your entire body.
The spine can get problems because of trauma or aging. It can also be a structural deficiency that got worse over time. Whatever the case, problems with the ligaments, discs, muscles, bones, and other structures of the spine can result in painful symptoms like numbness, swelling, inability to move, tenderness, stiffness and others. If left untreated this can become worse, resulting in permanent damage or making it impossible to operate without great risk.
2. What are the common surgical procedures?
Some of the more common spine surgery procedures are minimally invasive such as discectomy, decompression and fusion. For compression fractures there are kyphoplasty and vertebroplasty. Cervical (neck), thoraric, and lumbar (lower back) fusions can also be done with modern instrumentation. For decompression of the same parts (cervical, thoraric and lumbar), the popular options are discectomy, corpectomy and laminectomy. There are also anterior (front) and posterior (back) spine operations.
3. Are their surgical options that are less invasive?
Open surgery is often only done when the doctor needs a bigger space to work with, meaning the area to be operated on is too large, or there are some complications that prevent the use of less invasive equipment.
Most modern surgical treatment uses invasive methods to shorten recovery period. The use of endoscopes (remote-control cameras), fluroscopes (x-rays) and other imaging equipment often guide the doctor’s movements.
Less invasive procedures include anterior cervical decompression and fusion; anterior lumbar interbody fusion; cervical laminoplasty; kyphoplasty and vertebroplasty; and minimally invasive discectomy and decompression.
4. Will my primary physician say when I should get surgery?
Several doctors may be consulted to determine whether you do need to have surgery. Your primary doctor may consult a neurologist to check your medical history and x-rays. Your physical examination may also be repeated and a surgeon brought in to take a look.
If you are a prime candidate for spine surgery, your doctor will discuss the procedure with you. You may even be given options as to what procedure you prefer. The benefits and risks will be discussed and once you agree to a procedure and treatment plan, preparations for your surgery will begin.
5. If I agree to have surgery, when will it happen?
Preparation for the surgery normally takes two to three weeks. Additional tests may be done, like x-rays and blood tests. In cases where the need for surgery is immediate, this can be expedited to at least two to three days.
6. Is there any way I can use my own blood for my transfusion, if needed?
You can donate your own blood before surgery so that you can use it if the need arises. Preparations should be made with your doctor.
7. What is a pre-admission appointment?
This is an appointment scheduled prior to your surgery to discuss it. More exams and lab tests may be done at this time. You may also be briefed on how to handle post-operative care at home. If you need assistance after surgery, you may be asked to bring the person who will help you.
This is the best time to ask any questions about the procedure. Bring a list of any medication you are currently taking, including when and how frequent you take them. If you have other conditions, like diabetes or a heart problem, make sure to tell the attending physician so that they can advise you on how to proceed. This may also be the time when you will meet the anesthesiologist who will handle your operation.
8. When will I be admitted for surgery?
You will be admitted to the hospital the morning of your surgery.
9. What should I do about my medication?
Don’t take any anti-inflammatory medication or aspirin. If your medication includes anticoagulants like Lovenox or Coumaidn, your surgeon will tell you when to stop taking them.
10. Should I eat anything before my operation?
You’re not supposed to eat or drink anything eight hours prior to surgery. If you do have prescribed medication that your doctor tells you to take, take a small sip of water when swallowing it.
11. How long is the surgery?
This actually depends on the procedure. Your surgery can be as short as two hours. But surgery that lasts four to six hours is normal. Whatever the case, make sure to allow for about 2 hours of time spent in the recovery room.
12. What materials will be used in my surgery?
All tools and materials used in your spinal surgery are designed not to have conflict with your body. This means the use of metal alloys or titanium.
13. Is spinal surgery painful?
As with other surgical procedures, spinal surgery has some pain involved. Of course, this won’t be felt during surgery because of anesthesia. After surgery, pain can easily be managed with patient-controlled anesthesia. During recovery, this can then progress to Vicodin, Percocet or other oral pain medication. Once the patient leaves the hospital, a smaller dosage of pain medication can be prescribed.
14. What kind of anesthesia will I have?
The norm would be general anesthesia.
15. What complications can happen?
Spinal surgery actually ha a very low rate of complications. However, chronic illnesses may be a factor in increasing risk. Less than 3 to 4 percent of patients nationwide experience infection of the joint or other complications. While infections are the most common problems after surgery, it can be avoided with good pre-operative care. Antibiotics and low-impact exercises should also be started as soon as possible to help prevent it.
16. How long will I have to stay in the hospital?
On average, spinal surgery patients stay in the hospital about one to five days. However, the kind of procedure you have may change this.
17. Is it normal for the incision to bleed after surgery?
Some blood that soaks through the dressing of the incision is no cause for alarm. If this happens when you’re already home, just reinforce the dressing with more sterile gauze. However, this should have stopped in the hospital. If it continues, call your doctor immediately.
18. What will I do if there’s no one to help me with post-operative home care?
Most patients rely on close friends or family members to help them with post-operative care at home. In case you are unable to make similar arrangements, you can stay in a skilled nursing facility. Some hospitals have one on premise, while others can refer you to a reputable one. If you wish, they can also refer a home health care service for you.
19. How long do I need home care help?
After you are discharged from the hospital, you need assistance doing everyday activities for about three to five days. However, it is recommended that you have someone assisting you for a week or longer in case of emergencies. If you’re not able to make arrangements on your own, the hospital can refer a service for you.
20. What should I do after surgery?
Get some rest to give your spine time to heal and avoid instances where you could fall or injure your back. At this time, you are trying to regain your flexibility, strength and balance. Do not squat, cross your legs or sit in low seats or chairs for any reason. Your physical therapist will let you know when you’ve regained full use of your body.
21. How do I take care of my incision/s?
In about two to three days, your surgical dressing will be removed. Its ok to keep the wound uncovered if there is no drainage or bleeding. Always make sure that the incision is dry before the sutures are removes. At around two weeks after the surgery, the sutures will be removed.
22. What do I do with the pain?
Your pain level should be decreasing steadily in the days following your surgery. After you are discharged you will be given a prescription. It is important that you follow this exactly even when you are not feeling pain. The medication helps manage the pain before it gets worse. The drugs can have some side effects such as constipation, nausea and/or itching.
23. In what instances do I need to report to the hospital?
Call your doctor if you have redness, bleeding, or drainage on your wound; a fever over 101 degrees; increased swelling; unexplained weakness, persistent headaches or lightheadedness; extreme weakness of the bladder or bowel; and severe pain that cannot be treated by the prescribed medication.
24. When can I go back to my normal activity level?
It takes about three to four months after surgery before the patient can engage in some light activities and exercises. In any case, you should discuss this with your physical therapist. He or she will advise you based on your own progress.
25. Do I need to use a walker?
Immediately after the surgery, you may need a walker while you are in the hospital. During the rehabilitation period, your physical therapist may switch you to crutches or a cane.
26. When can I drive again?
Most people are able to properly drive cars for short distances around two to six weeks after surgery. However, patients are asked not to operate vehicles with manual transmissions, as this requires extra effort and movement. Your physician will tell you during rehabilitation when you can start driving normally again.
27. When can I go back to work?
For sedentary work, you can resume about eight to twelve weeks after your operation. While at work, you still need to follow your doctor’s orders: no heavy lifting, bending, squatting, or stooping.
28. Will I need any physical therapy?
After surgery, your physical therapist will help you go from your bed to a chair. This is the start of your physical therapy, since it’s important to get moving as soon as possible. During your first day after the operation, you will be assisted and trained to stand upright and walk a short distance. You will still need physical therapy about three to six times a week for around three to six weeks. You can make arrangements with the hospital so you can come in for their physical therapy program.
29. Is physical therapy always included in health insurance policies?
It actually depends on the policy you have. Check to make sure if there are provisions in your policy for both physical therapy and continuous passive motion. You also need to check how many sessions of therapy are covered in your insurance.
30. How long will the effects of the surgery last?
The surgery, including any implants and procedures, is meant to last for life. Recurrence may happen if you were misdiagnosed or if an underlying cause of your spine problem was not treated.