Our spine not only gives support and structure to our body, it also protects the extremely delicate spinal cord from damage. However, strenuous activity, trauma, birth deformities, different types of malignancies, weightlifting, and certain infections and diseases could cause damage to the spinal cord, thereby causing symptoms such as pain and stiffness in the back, numbness, sensation of 'pins and needles' in the legs, and many other problems. Minor problems may resolve with drug therapy coupled with exercise and rest. However, surgical intervention becomes a necessity in the event of serious damage. Usually, problems related to bones of the spine (vertebrae) or the intervertebral discs (cushioning structures in between the vertebrae) require surgery.
Recovery According to Type of Surgery
Recovery from back surgery depends on the patient's age, type of surgery, fitness level before the surgery, type of work you do, and how well you adhere to the lifestyle changes recommended by your physician.
I. Discectomy: This type of surgery is recommended for treating a herniated disc, which is commonly known as a slipped disc. In case of a herniated disc, the outer covering of the disc ruptures due to wear and tear, and the inner part bulges out. If it puts pressure on the surrounding nerves, it may cause pain, weakness or numbness in the legs. Also, with advancing age, discs tend to reduce in size, which can cause spinal stenosis. In such cases, surgery is performed to remove the damaged part of the disc.
Time of Recovery: People who have undergone cervical discectomy can get back to light work by 2 - 3 weeks, and to more demanding work in around 3 months time. Those who have undergone thoracic discectomy can resume work after around 2 months. For patients who have undergone lumbar discectomy, numbness usually does not go away until 2 weeks after the surgery. People who have undergone this surgery can get back to work in about 2 - 4 weeks, if the work involved is not strenuous. It would be best to wait for 2 - 3 months before getting back to work that may be physically demanding.
II. Laminotomy and Laminectomy: The lamina is a bony covering at the back of the spinal canal. The procedure that involves removal of the whole lamina for the purpose of reaching the disc is called laminectomy. The procedure that involves removal of only a small portion is known as laminotomy. Both procedures are performed to access a damaged herniated disc.
Time of Recovery: Those who have undergone cervical laminectomy may return to non-strenuous work after 6 - 12 weeks. Cervical laminotomy patients require only around 2 - 4 weeks to get back to normal work. Lumbar laminectomy patients require 1 - 2 weeks to return to work that is not of a strenuous nature. If the patient has a job that is physically demanding, he/she should resume work only after 3 - 4 months have gone by. Lumbar laminotomy patients should wait for at least 1 - 2 weeks before resuming work of a sedentary nature. They should wait for at least 2 months before indulging in physically strenuous work.
III. Foraminotomy: For patients suffering from spinal stenosis, the surgery involves widening of the foramen, which is the opening between the vertebrae. This is done so that the nerve roots (which pass through this opening) are relieved of the pressure that is caused by its narrowing.
Time of Recovery: After lumbar or cervical foraminotomy, most people can return to light work after 3 - 4 weeks, and to more demanding work after 2 - 3 months have gone by.
IV. Spinal Fusion: Spinal fusion is recommended for treating chronic back pain, spinal instability, scoliosis, spondylolisthesis or degenerative disc disease. In this procedure, two vertebrae are fused together. The procedure involves removal of the disc located between them, and placement of bone grafts. After the surgery, the grafts heal and secure the vertebrae in place. A person who has undergone this surgery has restricted movement afterwards because of the fused spine. The use of this surgery for relieving chronic lower back pain is controversial.
Time of Recovery: Patients who have undergone cervical fusion can resume light work after 5 - 6 weeks. Patients with a physically demanding job may need to wait up to a year before resuming their work. Those who have undergone thoracic fusion must wait up to 2 months before they resume work that is not physically strenuous. They will have to wait up to 6 - 7 months before returning to strenuous work. A person who has undergone lower lumbar spinal fusion may take 4 - 8 weeks to get back to work, provided that the patient is young and was previously in good health. For older patients, it takes at least 6 months to fully recover.
If a minimally invasive technique is employed for any of the aforementioned back surgeries, the recovery period would be shorter. Damage to the surrounding organs and tissues, bleeding, infection, scarring and other risks that are associated with an open surgery would be reduced in such procedures due to the smaller size of incisions. However, every patient may not be a suitable candidate for a minimally invasive back surgery.
Tips for Quick Recovery
- Pain Management: Most people experience pain for the first few days after surgery. For managing this pain, patients are fitted with a PCA (Patient Controlled Analgesia) pump. The patient just needs to press a button to deliver a fixed dose of a painkiller into his or her body.
- Avoid Smoking: Smoking delays recovery because the nicotine causes the blood vessels to constrict. The constriction hinders the supply of blood, and consequently the supply of nutrients to the bones. This can have an adverse effect on the recovery process.
- Take Small Walks: It is advised that a person who has undergone any kind of spinal surgery should begin to take walks as soon as he or she is fit to do so. This will not only help him/her regain flexibility but will also facilitate speedier recovery.
- Do Not Take NSAIDs: Certain non-steroidal anti-inflammatory drugs or painkillers should be avoided for at least 2 - 3 months after surgery. That is because they are blood-thinners that delay healing. Some examples are aspirin, ibuprofen, meloxicam, etc.
- Start Exercising: You can start performing some exercises after 6 - 8 weeks of surgery. For this, it is advisable to consult your doctor. He will recommend a qualified physiotherapist, under whose supervision you will perform the necessary exercises.
- Avoid Lifting Heavy Objects: Lifting objects heavier than 5 - 6 pounds can put strain on your already vulnerable back. You may even end up injuring it again in the process. Confine yourself to lifting only light objects, when necessary.
- Wear Compression Stockings: People undergoing any kind of spinal surgery are at a risk of developing Deep Vein Thrombosis (DVT), or blood clots in the large leg veins. These clots can travel up to the lungs and can cause serious complications. This is because, following the surgery, patients are not able to move about as frequently as they used to before. To prevent DVT, compression stockings should be worn for 1 - 2 weeks after the surgery.
- Do Not Bend: If you want to lift something, slowly bend your knees and lower yourself down to reach the object. Ensure that your back is straight as you lift the object. Do not sit in a low-lying chair. This is because you may strain your back while getting up.
- Bowel Movements: You may have constipation issues after surgery. The painkillers that are prescribed after surgery may cause severe constipation. Physicians usually prescribe a stool softener to deal with this problem. Apart from that, drink a lot of water and follow a fiber-rich diet to keep constipation at bay.
- For Sleeping: You can sleep on your side with a pillow in between your legs. You can also sleep on your back a few days after the surgery.
- For Bathing: You can shower, but are not allowed to immerse the wound in water, so do not bathe in a bathtub until your wound has fully healed.
Contact Your Doctor If...
- The wound has become red, looks inflamed and is oozing several days after the surgery
- You have developed a fever
- You are experiencing excruciating pain in the back, or pain, numbness or tingling in the legs several days after the surgery
- There is a foul odor from the wound
- You are having difficulty with micturition or bowel movements
Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a replacement for expert medical advice.