Recovery

Quitting Smoking Before a Spinal Fusion

Greg — Mon, 17 Mar 2008 09:55:47 -0700

An extensive amount of research has firmly established that cigarette smoking is bad for patients undergoing lumbar fusion surgery. But just how bad is smoking? How does it impact a spinal fusion? What do I need to know to help my chances of successfully quitting smoking? This article addresses those questions and more.

Smoking causes a number of significant problems for patients undergoing spinal fusion including the following:

Vigorous Low Impact Conditioning for Rehabilitation

Ben Parr — Mon, 16 Mar 2009 13:23:40 -0700

In addition to stretching and strengthening exercises, regular aerobic conditioning 9-12 weeks after lumbar fusion surgery is also important to help the fusion set up well. Regular aerobic exercise, even if it is just walking at a brisk pace for at least twenty minutes, will increase blood flow and oxygen. It will also burn excess calories, thus maintaining weight and preventing added stress on the back structures and surgical site.

Swimming Exercise to Strengthen the Low Back

Ben Parr — Mon, 16 Feb 2009 13:58:21 -0800

A physician answers patient questions about effectiveness of swimming to strengthen the lower back.

Question: What's the Best Swimming Technique for Spinal Fusion Patients?

I was wondering what the best swimming technique would be for spinal fusion patients. I have recently seen a yellow tubing that you wrap around your waist to help keep you afloat; I was never a good swimmer anyway; just looking to swim to strengthen the back in the best manner.

Spondylolisthesis Spinal Fusion Surgery: Postoperative Care

Ben Parr — Thu, 22 Jan 2009 10:24:06 -0800

After a spinal fusion surgery for spondylolisthesis, the patient will be hospitalized for one to five days. Early ambulation is encouraged as walking helps limit the chances of postoperative complications, such as deep venous thrombosis or pneumonia. It is also very gentle on the spine and can enhance healing.

After Posterolateral Gutter Fusion Surgery: Risks and Complications

Ben Parr — Tue, 20 Jan 2009 12:00:20 -0800

After posterolateral gutter spine fusion surgery, the body engages in a natural process to repair itself, which usually means growing bone. As the harvested bone graft grows and adheres to the transverse processes, such as between L4 and L5 (lumbar segment 4 and lumbar segment 5), the spinal fusion is achieved and motion at that segment is stopped. Spine surgery instrumentation (medical devices, such as pedicle screws or cages) is sometimes used as an adjunct to obtain a solid fusion.

Multilevel Spinal Fusion: Surgery, Risks, and Recovery

Ben Parr — Fri, 22 Aug 2008 14:31:47 -0700

Multilevel fusion surgery

Techniques involved in multilevel spinal fusions are similar to those of single-level fusions for degenerative disc disease. The ‘menu’ of potential surgical approaches, bone graft options, and cage and instrumentation possibilities are the same as for one level fusions. This includes posterior approach only, anterior approach only, or a combined anterior and posterior approach surgery, which is more common in multilevel fusions.

Anti-Smoking Medications: Zyban and Chantix

Greg — Wed, 02 Apr 2008 10:06:01 -0700

Currently there are two main prescription medications that may be prescribed to help people quit smoking: Zyban and Chantix.

Zyban (bupropion)
Bupropion is a prescription anti-depressant medication marketed under the brand names Wellbutrin (for depression) and Zyban (for smoking cessation). Zyban does not contain nicotine and is thought to affect chemicals in the brain that are related to nicotine craving. Zyban can be used either alone or in conjunction with nicotine replacement therapy.

Achieving a Spinal Fusion in Smokers

Greg — Mon, 17 Mar 2008 12:34:05 -0700

As this article discusses in detail, the best approach for achieving a successful outcome (e.g. reduced pain) in a spinal fusion patient who smokes is for that person to quit smoking, permanently. Unfortunately, not all patients are able or willing to quit smoking and alternative surgical procedures have been developed to help offset the negative influence of smoking.

Reasons to Quit Smoking Before Spinal Fusion

Greg — Mon, 17 Mar 2008 11:07:15 -0700

Studies have demonstrated that the rate of non-fusion in smokers is as much as twice that found in non-smokers. Although the studies on non-fusion rates are highly variable depending upon the procedures used, the fusion rates for non-smokers is about 5% to 15% whereas in smokers it is approximately 20% to 30%, or higher. Most theories as to why this occurs relate to the negative effects nicotine has on bone growth (which is essential for achieving a spinal fusion).

Postoperative Care for Decompression/Fusion Surgery

spine-health — Wed, 12 Dec 2007 00:21:10 -0800

Immediately after the surgery, patients will experience some difficulty swallowing or a sore throat due to manipulation of the esophagus. This usually resolves within several days, but symptoms may persist to a troublesome degree.

The pain associated with the procedure is relatively minimal, as most of the exposure is obtained by dissecting tissue, not dividing it. Pain at the graft site (where bone graft is obtained from the hip) is more of a concern if iliac crest graft is utilized.

Maximize the Ability to Heal After Spine Fusion Surgery

spine-health — Wed, 12 Dec 2007 00:21:08 -0800

Healing after spine surgery

One of the risks of any spine fusion surgery is a lack of healing of the bone graft, which is known as a pseudarthrosis. There are a number of factors that can affect this outcome after spine fusion surgery. These can include:

Poor nutrition
Osteoporosis
Previous back surgery
Multiple level spine fusion surgery
Severe deformities
read more

One to Four Weeks After Spine Fusion Surgery

spine-health — Wed, 12 Dec 2007 00:21:08 -0800

One of the risks of any surgery is infection. This occurs about 1% of the time. Some people, (e.g., diabetics), are more prone to infections.

Wound infections usually present at about 10 days after surgery. Some symptoms to look for include:

Fever (101 degrees or higher)
Expanding redness at the incision site
Increasing pain
Change in the amount, appearance or odor of drainage

If these signs develop it is important to contact your surgeon immediately.

Moving from Static to Dynamic Exercises

spine-health — Wed, 12 Dec 2007 00:21:08 -0800

After the initial 6-week recuperation period when the focus is on getting back to feeling good, more advanced exercise should be added to strengthen the back structures and increase overall fitness. Patients can add more rigor and variety to their routines by using an exercise ball or resistance bands. The exact timing of when a surgeon will recommend adding dynamic exercises is dependent on both the quality of stability achieved at surgery and the surgeon’s own personal preference.

Postoperative Care for Spinal Fusion Surgery

spine-health — Wed, 12 Dec 2007 00:21:08 -0800

Spine fusion surgery recovery

More Spinal Fusion Info:

Cervical Spinal Fusion

Lumbar Spinal Fusion

Fusion Surgery Recovery

Bone Grafts

Arrange for Assistance at Home and Work

spine-health — Wed, 12 Dec 2007 00:21:08 -0800

Following a spine fusion your ability to do many activities will be limited. This can include normal daily activities and occupational duties. It is best to make arrangements before surgery to have these needs met.

The extent of the assistance you may need depends on many things:

Specific type of fusion surgery to be completed
Your age
Nerve function
read more

At the Hospital (one to two days) After Spine Fusion Surgery

spine-health — Wed, 12 Dec 2007 00:21:08 -0800

Pain medication after spine fusion

Immediately after spine fusion surgery there is a need for pain medication. This is often given in the vein or by “hypo” (injection of medication into the muscle of the arm or leg). Within a couple of days, as the pain decreases, this can be changed to oral medication.

Prepare for Blood Loss

spine-health — Wed, 12 Dec 2007 00:21:08 -0800

Often the amount of blood that is lost is quite small, but excessive bleeding during a spine fusion is always a possibility.

One to Three Months Post-Op After a Fusion Surgery

spine-health — Wed, 12 Dec 2007 00:21:08 -0800

During the initial few months following a spine fusion, it is best to avoid excess motion and stress at the fused segments. It is during this time that the fusion bone mass is becoming established. Certain types of movement to avoid include:

Excess lifting (anything over 10 to 15 pounds)
Bending
Twisting
read more

Rehabilitation Following Lumbar Fusion

spine-health — Wed, 12 Dec 2007 00:21:08 -0800

Staying active speeds recovery from fusion

Patients who have had or are contemplating lumbar fusion surgery are understandably concerned about making sure the fusion heals as intended. For this reason, many patients are afraid to be active and some do not want to move at all, fearing that they will risk having the fusion not set up properly. In actuality, and contrary to this fear, movement is very important to foster healing.

Three Months and After

spine-health — Wed, 12 Dec 2007 00:21:08 -0800

As the fusion matures, it is necessary to begin a reconditioning program. It is well established that people with spinal problems fair best when they get in better shape.

After Discharge (three to six days)

spine-health — Wed, 12 Dec 2007 00:21:08 -0800

Following discharge from the hospital, the patient will likely still have pain. This is managed with pain medication. If a narcotic is prescribed, the patient should not drink alcohol or operate a car, because this type of medication may cause drowsiness and/or impaired judgment.

Some surgeons also recommend application of an ice pack to manage postoperative pain. Ask your doctor if this is appropriate for you and for instructions on how to apply the ice.

Spine Fusion Post-Operative Care

spine-health — Wed, 12 Dec 2007 00:21:07 -0800

Attention to appropriate post-operative treatment is critical in leading to a successful spine fusion outcome. After a spine fusion surgery, it takes approximately three months for the fusion to successfully set up and achieve its initial maturity. During these first three months, it is necessary to avoid activities that may place the bone graft at risk. Therefore, surgeons will usually restrict activities that involve lifting, twisting or bending the lower back, or vigorous activities, such as running and other sports.

Guidelines for Recovering from Low Back Pain

spine-health — Wed, 12 Dec 2007 00:18:36 -0800

More Low Back Pain Info:

Low Back Pain Causes

Low Back Pain Treatment

Coccydynia Introduction

Mattresses for Low Back Pain

In addition to stretching, strengthening and aerobic exercises, there are several lifestyle guidelines that can help in the healing and rehabilitation process.

Rehabilitation and Exercise for a Healthy Back

spine-health — Wed, 12 Dec 2007 00:18:36 -0800

How the back benefits from exercise

People who suffer from lower back pain are often encouraged to help their own recovery through exercise and physical therapy, but are seldom given the knowledge and tools needed to accomplish this.

Scar Tissue and Pain After Back Surgery

spine-health — Wed, 12 Dec 2007 00:03:17 -0800

Effects of scar tissue on back pain and leg pain

The formation of scar tissue near the nerve root (also called epidural fibrosis) is a common occurrence after back surgery—so common, in fact, that it often occurs for patients with successful surgical outcomes as well as for patients with continued or recurrent leg pain and back pain. For this reason, the importance of scar tissue (epidural fibrosis) as a potential cause of postoperative pain—commonly called failed back surgery syndrome—is controversial.

Successful Recovery from Back Surgery - Patients' Advice: Part IV

spine-health — Wed, 12 Dec 2007 00:03:17 -0800

Back-to-Back

Patients share tips on achieving a successful recovery from back surgery
In this section, patients share tips and advice about what helped them most during their post-surgical recovery.

Say no to overdoing it

I had a microdiskectomy march 2007 and have had amazing results I am not what I used to be, but at least I can walk without pain. I have for the most part full range of motion and feel that I made the right choice to have the surgery. Words of advice: Never over do it!
read more

Successful Recovery from Back Surgery - Patients' Advice: Part III

spine-health — Wed, 12 Dec 2007 00:03:17 -0800

Back-to-Back

Patients share tips on achieving a successful recovery from back surgery
In this section, patients share tips and advice about what helped them most during their post-surgical recovery.

I was pain free right after my back surgery

read more

Treatment Options for Pain After Back Surgery

spine-health — Wed, 12 Dec 2007 00:03:17 -0800

It must be kept in mind that postoperative imaging studies will almost always show scar tissue involving the nerve root and surrounding structures, a phenomenon known as the post-laminectomy membrane. Much clinical and animal research has been done on the nature and significance of this scar tissue, but it has not been conclusively shown that scar tissue is a major cause of back pain or leg pain after spine surgery.

Successful Recovery from Back Surgery - Patients' Advice: Part III

spine-health — Wed, 12 Dec 2007 00:03:17 -0800

Back-to-Back

Patients share tips on achieving a successful recovery from back surgery
In this section, patients share tips and advice about what helped them most during their post-surgical recovery.

Surgeon recommended laminectomy for sciatic pain

I tried chiropractic care for over a year, acupuncture, and stretching. MRI confirmed severe bulging disk at L5-S1. Finally had sciatic pain down my left leg for 2 months. Tried ESI, didn't work.
read more

Return to Exercise After Microdiscectomy Surgery

spine-health — Wed, 12 Dec 2007 00:03:15 -0800

Healing faster with exercise

Early mobilization and exercise may help patients heal sooner, as the pre-operative pain has usually caused patients to limit their motion, and limited motion is a common cause of pain. In addition to an early exercise program of stretching, strengthening and conditioning, return to normal daily activity may also help improve the secondary soft tissue component of the pain after microdiscectomy back surgery.

Pain Management After Microdiscectomy Surgery

spine-health — Wed, 12 Dec 2007 00:03:15 -0800

Immediate post-operative pain can be managed with a combination of non-steroidal anti-inflammatory drugs (NSAID’s) and a mild pain pill (e.g. Darvocet, Vicodin). The narcotic pain medications (Vicodin) are addictive and should only be used for a short period of time (less than two weeks).

As the discomfort from back surgery subsides (usually about 1 to 2 weeks) the patient can move towards substituting Tylenol for the narcotic pain medications.

Stretching Exercise after Microdiscectomy Surgery

spine-health — Wed, 12 Dec 2007 00:03:15 -0800

Since any surgical site will heal with scar tissue, some surgeons feel that to minimize scarring of the nerve root, gentle stretching exercises should be done in the early postoperative period.

The stretching exercises should be done about 5 to 6 times a day for 6 to12 weeks, since this is the time period in which the scarring occurs.

The safest way to stretch is to lie down and maximally flex the hips and gradually extend the knee. This maneuver will also stretch the hamstring muscles, which is important for rehabilitation of the back.

Rehabilitation After Spine Surgery

spine-health — Wed, 12 Dec 2007 00:03:13 -0800

Top Back Surgery Topics:

Back/Neck Surgery Intro

Microdiscectomy

Lumbar Laminectomy

Lumbar Spinal Fusion

Scar Tissue and Continued Pain After Back Surgery

spine-health — Wed, 12 Dec 2007 00:03:13 -0800

Top Back Surgery Topics:

Back/Neck Surgery Intro

Microdiscectomy

Lumbar Laminectomy

Lumbar Spinal Fusion

Getting Adequate Pain Control After Back Surgery

spine-health — Wed, 12 Dec 2007 00:03:12 -0800

Effective pain control after surgery can help the overall success of the back surgery. Almost all surgical procedures cause mild to severe postoperative pain, and this is one of the greatest worries of many back surgery patients. Even so, patients are rarely prepared for the type of pain they will experience after the operation, and a systematic pain control approach is rarely used.

Practical Advice for Recovering from Back Surgery

spine-health — Wed, 12 Dec 2007 00:03:12 -0800

Back surgery postoperative care

For patients who have decided to have back surgery, taking time to prepare for the post-surgical recovery period is a good idea and will usually improve their experience when they get home.

Rehabilitation and Exercise Following Spine Surgery

spine-health — Tue, 11 Dec 2007 23:04:47 -0800

Rehabilitation and exercise for spine surgery recovery

Spine surgery is a major undertaking, and rehabilitation is an important part of helping patients get the most possible benefit from their surgery. Essentially, rehabilitation (physical therapy, exercise) can help patients recover from spine surgery as quickly and completely as possible.

Physical Therapy After Minimally Invasive Back Surgery

spine-health — Tue, 11 Dec 2007 23:04:47 -0800

When a surgery is minimally invasive, many people – especially those who experience a great deal of pain relief – may think that physical therapy is unnecessary. It is very important that muscle function is at its best after any spine procedure in order to maximize recovery and to minimize potential future problems.

Depression Can Lead to Chronic Back Pain

spine-health — Tue, 11 Dec 2007 21:24:26 -0800

More Depression Info

Depression and Back Pain

Depression Guide

Stress and Back pain

Chronic Pain Overview