Pre-Operative & Post-Operative Information
On those occasions when the person to undergo surgery has general health concerns (with the heart or lungs for instance) it is wise to arrange for review by an anaesthetist or a physician at the hospital where the surgery will take place, but well ahead of the surgery date. This provides for specialised care in the immediate post-operative period, helping reduce the risk of complications.
You will need to print and complete the Medical History Form and then bring it with you when you have your appointment with Dr Stanford.
Click here to access the form.
Some medications have a major impact on surgery and the early post-operative period. Amongst the most important are medications that reduce clotting (“thin the blood”) and these may need to be stopped well before surgery because of possible bleeding problems. This group includes warfarin, clopidogrel (Plavix, Iscover), ticlopidine (Ticlid, Ticlopidine Hexal, Tilodene), all aspirin containing medications and all of the anti-inflammatory agents. However, do not stop taking any medicines before discussing them with your surgeon.
Always tell your surgeon about any allergies to drugs so as to avoid potentially serious problems.
Admission to Hospital
Once a plan for surgery has been decided upon, bookings will be made with the appropriate hospital. In most cases, admission to hospital is on the morning of the day of surgery. Nursing staff will supervise preparations for surgery on the ward and the anaesthetist will make a visit shortly before the time of surgery.
- Pain relief - Local anaesthetic is used in the wound to help dampen pain sensations from the cut in the soft tissues. This will be backed up by use of morphine and related drugs to take away the severity of the pain from the surgery. Often, the delivery of these drugs is controlled by the person who has had the surgery by way of a button attached to a pump
- Mobilising - Sitting up is encouraged very soon after surgery as it allows fuller breathing and better oxygenation. Standing and walking are started the day after surgery and may be supervised by the physiotherapist in the first instance
- Stitches and dressings - I use buried, absorbable stitches in the skin that do not require removal. In the first two days or so, the first dressings will become soaked by fluid from the wound and will be changed. Before discharge from hospital a clear, rubbery dressing will be applied that can stay on for a week or more until the wound heals. Showers may be taken during that time
- Nerve pain - Although many people experience early relief from their pain following surgery, some have residual pain that takes weeks to settle. This is due to nerve inflammation as a result of the original compression or the surgery
First Two Weeks
- Expected levels of pain - The operative site will be sore, but improving
- Wound care - Leave the dressing that was applied at discharge from hospital intact. It should be removed 10 days after the day of surgery
- Activity level - It is best to keep active, but gently does it. Walking on level ground without pushing beyond reasonable discomfort is advised. Lying down all the time leads to loss of muscle tone and increased medical complications
- Pain relief - Tablets will be prescribed at the time of discharge and should be taken as directed
- Emotions and tiredness - It is not unusual to feel down after an operation and so allow for this in your plans when you leave hospital. Your spirits will naturally improve with a little time and gentle activity
- Travelling in a car - Being a passenger in a car will not harm you neck or back, but may make them painful. If trips in a car are necessary, then try to make them short or break them up with stops for a walk at least every hour. It is important to sit up properly in the car seat and wear a seat-belt for safety reasons and to avoid breaking the law
- Increasing activity - The first milestone in recovery is at about 6 weeks. After this time it is good to increase activity levels in a sensible way and start resuming your usual roles at home and/or work. For those with physically demanding work, resumption of work will take longer. Some people will be able to return to work earlier
- Driving a car - Do not expect to drive any vehicle until 6 weeks after surgery. This is because pain in the neck or back could prevent you from controlling the vehicle safely
- Recovery of function - Full recovery often depends on commitment to regular exercise in order to build up muscle and stamina that was lost due the original condition and then the surgery
- Keeping fit - Commonly, the need for spine surgery comes about because of a degenerative problem in the spine, which may have been exacerbated by an injury. This means that your spine as a whole needs to be looked after, even though surgery has relieved painful symptoms. The spine benefits from regular exercise and keeping down to a healthy body weight. The exercise does not need to be strenuous, but should be regular and tailored to your level of fitness and strength. The basic minimum is walking for 30 minutes each day. Swimming is good for the back and some people like to visit a gymnasium. If planning to use a gym, ensure that you use a program that is safe for your back