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Recovering from Back Surgery

14 April 2003

by Emma West (Physiotherapist)

The ultimate success of your back surgery is largely dependent on what you do, and just as importantly, what you do not do in the early post-operative stages, as well as long term. While each surgeon will have different recovery procedures, the following are general guidelines of what to expect following back surgery.

Immediately following surgery

After the operation you will be transferred back to the ward. You will be given pain relief as required, which will be gradually reduced during your stay in hospital. You are likely to have a small drain tube in your back, which is generally removed the following day, along with a drip to administer intravenous fluids. You may require a small amount of oxygen until you start to wake up from the anaesthetic. This too will be reduced soon after returning to the ward. The nurses will check your vital signs (eg. Blood pressure, temperature, pulse) regularly, as well as the movement and sensation in your legs.

The physiotherapist will generally begin your rehabilitation the day after your surgery. This will include:

  • Education regarding appropriate ways to get in and out of bed,
  • commencing abdominal strengthening exercises to help support the spine,
  • education on how to manage daily activities, and
  • explanation of what you can and cannot do following surgery.
It is now thought that early mobility is the best approach in the post-operative management of patients who have undergone spinal surgery. While individual surgeons will have different restrictions on what activities patients can and cannot do post-operatively, and some types of surgery do require a period of bed rest (e.g. multilevel spinal fusion), the majority of patients undergoing spinal surgery generally get out of bed and walk the day following their operation. Some patients may even find they are able to move around hours after returning to the ward.

Your physiotherapist will also provide advice on posture, exercise, safe lifting and how to care for your back in the short and long term. This includes progression of exercises over the first couple of months following surgery until you are able to return to normal activities, including work and sport.

Precautions/Restrictions

Some of the more common restrictions following back surgery include:

  • NO prolonged sitting (ie 15-20 minutes) for patients following discectomy for up to six weeks
  • NO bending or twisting of the back
  • NO heavy lifting: most surgeons recommend you do not lift weights heavier than 5 kilos.
Going Home

Most patients are only in hospital for a few days following routine spinal surgery. Before being discharged, you need to be medically stable as well as safe getting in/out of bed and walking around independently. There are various support services that can be put in place once you go home, for example home help with cleaning. Appropriate help will be assessed on a case-by-case basis. The occupational therapist may provide you with aids to help you at home if required. For example shower seats, over the toilet frames and long handled sticks to prevent you from bending your back. Pain relief medication will be provided while recovering at home. And you'll also be given an appointment to see your surgeon (usually in 4-6 weeks) as an outpatient.

Exercise

The best exercise in the early phase is walking and a walking program is an important component of your rehabilitation. This is discussed with your physiotherapist and involves a gradual progression of distance and time walked each week. The physiotherapist will also educate you on basic abdominal strengthening exercises. These exercises work on the muscles that will help to support your spine now and in the future. You may be referred on for follow up physiotherapy a few weeks after your surgery to progress these exercises. Contact sports are not allowed for at least 6 weeks following surgery. You will need to discuss your return to contact sport with your

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