Nowadays we mobilise and discharge people early after spinal surgery! Most people prefer it that way and there are considerable advantages including a greatly reduced risk of venous thrombosis and a more rapid return to normal activities. The vast majority of people have no problems and rapidly improve over the following weeks. Early discharge can cause concern though, especially in the first week, because you will still be feeling a bit uncomfortable and you are away from the reassuring environment of the hospital.
It is important to emphasise that your neck is perfectly stable, and that the following advice is given to reduce discomfort and promote mobility rather than through any concerns that you might do damage to your operation site.
You will normally have been discharged on the first or second post-operative day. It is normal to experience stiffness and discomfort in the neck which is due to muscular bruising and soft tissue welling. Your voice may be a little hoarse and your throat uncomfortable. It is a good idea to take painkillers regularly during the first week. A suitable medication will be discussed with you and prescribed prior to discharge.
If you had arm pain prior to surgery you may feel some intermittent tingling or discomfort in the arm due to nerve sensitivity. This is common and usually subsides gradually. If you had numbness before surgery it may take several weeks or even months to improve. If you had stiffness and weakness in the limbs prior to surgery as a result of spinal cord compression, improvement is usually very gradual.
I do not normally prescribe a collar as it is better to flex and turn your head instead of keeping it in a fixed position.
Men often notice the upper part of their neck above the wound is numb when they shave. This usually only lasts a few weeks.
You will be encouraged to take short walks which can be extended in length and duration after a few days. You can do mild household tasks provided they do not involve prolonged bending, heavy lifting or pulling. If you find even minor activities painful you should take plenty of rest. Unless you are feeling exceptionally well, It is advisable not to drive for the first week and to start again only when you can sit and use the foot controls comfortably. You should be able to turn with ease to look over your shoulder.
The skin incision is closed with streristrips rather than stitches and these should stay in place for a week. A top (Mepore) dressing is then applied which should be replaced if it gets wet. (You can shower or bathe but replace the mepore dressing if it gets very wet). After a week, the steristrips can be gently removed by a relative or friend (its best to soak them first), or you can attend your doctor or practice nurse if you prefer. Once the steristrips have been removed the scar can be left exposed.
If the skin wound is painful, appears red, or weeps fluid you should attend your G.P. or contact us for advice. Infection is exceptionally rare in Minimally Invasive Spinal Surgery but if it does occur it needs to be treated promptly.
The degree of discomfort and stiffness you experience at this stage will depend to some extent on how severe and how long you had symptoms prior to your operation. If, for example, you had been suffering for several months or even years, your neck and limb muscles will be weak and a return to comfort and normal mobility will be slower than if you had been experiencing trouble for only a few months..
At this stage you should be able to extend your walking distances and rely less on painkillers. Your neck is perfectly stable so you can engage in more physical activites in and outside the house which involve carrying , lifting , reaching or bending
Once you are comfortable and the wound is well healed, it is a good idea to attend a physiotherapist (link)for advice regarding exercises, posture and proper lifting techniques. If you have been experiencing weakness in a limb prior to surgery she (or he) will show you how best to go about regaining muscle strength and bulk.
RETURN TO WORK
If you are in a sedentary job you can usually return in a month or less. If you are in a more physical occupation, it is usually possible to return after six weeks. If you are comfortable at this stage you can return to golf and other sports. It is prudent to resume strenuous activities and sport on a gradual basis so as to reduce muscular strain and avoid reactive inflammatory changes in the joints of the spine.
If you have concerns about your postoperative progress,and cannot find the answers to your query in this section or in our FAQs, you can phone or email my office at 016459550 or firstname.lastname@example.org . In emergencies, Mr Young or a member of his team can be contacted 24 hours a day at the National Neurosurgical Centre, Beaumont Hospital, Dublin on 01 8377755.