No matter how established the procedure or skilled the doctor, one thing remains true: Every surgery feels major when it’s happening to you. Spinal fusion surgery is no exception. After all, there are many types of spinal fusion and many levels of spinal fusion, and the mere thought of undergoing a major surgery under general anesthetic can seem daunting. Patients may find themselves asking, “When is spinal fusion necessary? What will happen to me? What should I expect when I wake up?”
This post is written with those very concerns in mind! In it, we will explain the process of preparing for lumbar fusion surgery, what you should expect during and after your procedure, and how you can best care for yourself over the short and the long run.
What to Expect after Spinal Fusion Surgery?
So you’ve begun to prepare for spinal fusion. Due to disease, damage, or genetics, you need to have two or more vertebrae combined into a single unit. You’ve explored spinal fusion alternatives, and now you have the surgery scheduled. It’s natural to find yourself wondering what to expect after spinal fusion surgery.
Believe it or not, your recovery actually starts prior to your spinal fusion surgery. Your surgeon will ask you to stop all blood-thinning medications and supplements. He or she may also ask you to cease all tobacco and alcohol usage or to lose weight. Your degree of compliance has a direct impact on how well things will go for you during and after the procedure. Asian Spine Journal identified multiple patient-related factors that could lead to failed procedures, such as:
- Tobacco use
- Patient age
- Preexisting depression
- Poor psychosocial well-being
The more of these you can address, the better your chances of a positive surgical outcome, which we will discuss in further detail below.
Physicians can perform spinal fusions at different places on the spine, and the results of lumbar spinal fusion surgery can very well look different from a cervical spinal fusion surgery. However, there are some commonalities about any fusion procedure of which you should remain aware.
Because it is a procedure that requires general anesthetic, you will generally need to remain in the hospital for 24 to 72 hours. Immediately after your surgery, you will experience some discomfort, and medical personnel will administer analgesic as needed. They may also monitor you blood levels to ensure proper recovery, provide oxygen, and track your heart rate.
Fairly soon after surgery, an physical and/or occupational therapist will help you get up and move with the help of a walker. You will also learn how to safely dress, sit, stand, and manage stairs, all of which are activities that could potentially damage the spinal graft if not done correctly. You may also get fitted with a back brace to help stabilize your spine.
Taking proper care of your incision after surgery is of utmost importance. This involves keeping it dry for a day or two. You’ll likely only be allowed sponge baths since getting the incision site wet can slow healing and encourage infection.
Although most patients are discharged after a 2 to 3 day stay, you won’t be able to return home until you are able to do the following:
- Properly stand and move on your own
- Manage your pain using provided oral medications
- Show no signs of infection around your incision
How Can You Care for Yourself at Home?
Getting out of the hospital is a major step in the right direction as far as recovery is concerned. In many ways, though, it’s only the start of regaining your maximum functionality. While everyone suffers some permanent restrictions after spinal fusion, you can minimize that if you take some specific steps while caring for yourself at home. These steps include:
- Walking every 90 to 120 minutes while awake in order maintain muscle strength
- Pacing yourself to avoid overexertion
- Changing your position often in order to avoid sitting, laying, or standing for prolonged periods
- Icing four times a day around the incision site to reduce swelling
- Taking showers rather than baths and leaving your incision site open unless you are experiencing discharge
- Practicing the log-roll technique when getting into bed (i.e., keeping your knees pressed together, maintaining a straight back, and rolling like the proverbial log)
- Preparing several meals prior to undergoing your procedure
- Arranging aid from family or outside help to perform simple chores around the house
- Performing any exercises suggested for you by your doctor or occupational therapist
These suggestions should help speed your recovery, but sometimes complications can ensue. Understand that it’s normal for pain to persist for up to three months, and some patients even continue to experience it for up to six months. But if any of the following occur, contact a medical professional as soon as possible:
- Fever (medically defined as a temperature of 101 °F or more)
- An expanding red flush that radiates from the incision site
- Sudden bruising around your incision
- The edges of your incision coming open
- Increasing pain, weakness, and/or numbness or a tingling sensation in your limbs or extremities
- Foul-smelling, colored discharge
Such symptoms may indicate a serious infection that needs to be treated with a multi-week course of intravenous antibiotics or an additional surgical procedure to eradicate the infection.
Which Activities Should You Avoid?
Patients can forget that the vertebrae remain somewhat delicate for months after a successful spinal fusion procedure. The natural or artificial graft that bridges the discs in your spine takes time to grow and properly connect with your original tissue. In order to avoid jeopardizing it or the constituent materials in your spine, you should avoid several kinds of motion and various tasks:
- Minimize bending and/or twisting
- Don’t allow yourself to become constipated for more than two days (straining to defecate can cause further injury)
- Avoid non-steroidal anti-inflammatory medications for the first three months after surgery (e.g., Advil, Motrin, Nuprin, Midol,
- Don’t lift anything heavier than a gallon of milk (nothing heavier than five to 10 pounds)
- Avoid driving due to accident risks
- Don’t develop an overreliance on opioid painkillers, and try to use them for no longer than four weeks after your procedure
- Don’t sleep on your stomach
Factors that can Slow Down Recovery Time
While it’s important for you to avoid the above activities, there are some factors that play an outsized role in hampering your recovery and in manifesting negative long-term side effects of spinal fusion. For instance, one is failing to walk or exercise. It might seem counterintuitive to emphasize activity after a major surgical procedure, but careful regular movement provides a bevy of important benefits, such as avoiding clots and maintaining muscle tone, which can have a stabilizing effect.
Lifting, twisting, or bending too soon also spells trouble. Such actions can put strain on the new graft in your spine. Damaging it may cause your surgery to fail.
While everyone knows that tobacco is bad for you, continuing to smoke has a demonstrably negative effect on your recovery. A 2015 study published in Spine revealed that nonsmoking patient who underwent surgery for cervical myelopathy saw more than two-and-a-half times as much improvement as smokers. “Smoking may have a directly toxic effect on the intrinsic healing capability of the spinal cord,” the study’s authors concluded.
Finally, remaining obese makes it hard to heal. A 2017 study in Surgical Neurology International stated that morbid obesity was such a postoperative issue for patients that they should consider undergoing bariatric surgery prior to having a spinal procedure.
The fellowship-trained physicians at The Spine Center have more than five decades of experience in treating spine diseases, disorders, and injuries. Contact us today to learn how we can help!