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Definition

You were in the hospital for spine surgery. You probably had a problem with one or more disks or spine bones. A disk is a cushion that separates the bones in your spine (vertebrae).

Now that you're going home, follow the surgeon's instructions on how to care for yourself while you recover.

When You're in the Hospital

You may have had one of these surgeries:

• Diskectomy -- surgery to remove all or part of your disk
• Foraminotomy -- surgery to widen the opening in your back where nerve roots leave your spinal column
• Laminectomy -- surgery to remove the lamina, two small bones that make up a vertebra, or bone spurs in your back, to take pressure off your spinal nerves or spinal column
• Spinal fusion -- the fusing of two bones together in your back to correct problems in your spine

What to Expect at Home

Recovery after diskectomy is usually quick.

After a diskectomy or foraminotomy, you may still feel pain, numbness, or weakness along the path of the nerve that was under pressure. These symptoms should get better in a few weeks.

Recovery after laminectomy and fusion surgery is longer. You will not be able to return to activities as quickly. It takes at least 3 to 4 months after surgery for bones to heal well, and healing may continue for at least a year.

If you had spinal fusion, you will probably be off work for 4 to 6 weeks if you are young and healthy and your job is not very strenuous. It may take up to 4 to 6 months for older people with more extensive surgery to get back to work.

The length of recovery also depends on how bad your condition was before surgery.

Wound Care

Your bandages (or tape) may fall off within 7 to 10 days. If not, you may remove them yourself if your surgeon says it's OK.

You may feel numbness or pain around your incision, and it may look a little red. Check it every day to see if the incision:

• Is more red, swollen
• Is draining extra fluid from the wound
• Feels warm
• Begins to open up

If any of these occur, call your surgeon. You should also call if you have a headache that won't get better with usual medicines.

Check with your surgeon about when you can shower again. You may be told the following:

• Make sure your bathroom is safe.
• Keep the incision dry for the first 5 to 7 days.
• The first time you shower, have someone help you.
• Cover the incision with plastic wrap.
• Do not allow water from the showerhead to spray the incision.

Do not smoke or use tobacco products after spine surgery. Avoiding tobacco is even more important if you had a fusion or graft. Smoking and using tobacco products slows the healing process.

Activity

You will need to change how you do some things. Try not to sit for longer than 20 or 30 minutes at one time. Sleep in any position that does not cause back pain. Your surgeon will tell you when you can resume sexual activity.

You may be fitted for a back brace or corset to help support your back:

• Wear the brace when you are sitting or walking and as instructed by your surgeon.
• You do not need to wear the brace when you are sitting on the side of the bed for a short time or using the bathroom at night.

Do not bend at the waist. Instead, bend your knees and squat down to pick up something. Do not lift or carry anything heavier than around 10 pounds or 4.5 kilograms (about 1 gallon or 4 liters of milk). This means you should not lift a laundry basket, grocery bags, or small children. You should also avoid lifting something above your head until your fusion heals.

Other activity:

• Take only short walks for the first 2 weeks after surgery. After that, you may slowly increase how far you walk.
• You may go up or down stairs once a day for the first 1 or 2 weeks, if it does not cause much pain or discomfort.
• Do not start swimming, golfing, running, or other more strenuous activities until you see your health care provider. You should also avoid vacuuming and more strenuous household cleaning.

Your surgeon may prescribe physical therapy so that you learn how to move and do activities in a way that prevents pain and keeps your back in a safe position. These may include how to:

• Get out of bed or up from a chair safely
• Get dressed and undressed
• Keep your back safe during other activities, including lifting and carrying items
• Do exercises that strengthen your back and abdominal muscles to keep your back stable and safe

Your surgeon and physical therapist can help you decide whether or when you can return to your previous job.

Riding or driving in a car:

• Do not drive for the first 2 weeks after surgery. After 2 weeks, you may take short trips only if your surgeon says it's OK.
• Travel only for short distances as a passenger in a car. If you have a long ride home from the hospital, stop every 30 to 45 minutes to stretch a bit.

Pain Management

Your surgeon will give you a prescription for pain medicines. Get it filled when you go home so you have it available. Take the medicine before the pain becomes very bad. If you will be doing an activity, take the medicine about half an hour before you start.

When to Call the Doctor

Call your surgeon if you have any of the following:

• Chills or a fever of 101°F (38.3°C), or higher
• More pain where you had your surgery
• Drainage from the wound, or the drainage is green or yellow
• Lose feeling or have a change of feeling in your arms (if you had neck surgery) or your legs and feet (if you had lower back surgery)
• Chest pain, shortness of breath
• Swelling
• Calf pain
• Your back pain worsens and does not get better with rest and pain medicine
• Difficulty urinating and controlling your bowel movements

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References

Li Y, Ling MZ, Wang MY. Perioperative management protocols: enhanced recovery after surgery. In: Steinmetz MP, Berven SH, Benzel EC, eds. Benzel's Spine Surgery. 5th ed. Philadelphia, PA: Elsevier; 2022:chap 79.

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