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Post-op advice - spinal fusion

GENERAL ADVICE

Don't try to rush your recovery, even if you feel like doing more. Particularly in the first 6-8 weeks, the body takes time to heal and is more vulnerable to injury if you push things too much.

WOUND CARE

  • The sutures in your back are all below the skin surface and are fully dissolvable so no need to remove them.

  • Keep the wound dry over the first week. The sticky dressing is water-resistant and helps to do this. You can remove it after 7 days.

  • The Nurses will also talk to you about wound care for when you are discharged.

  • Let your surgeon know through the rooms or the hospital if there is any increasing pain (more than taking some standard painkillers can help with), swelling, redness or if you develop a fever.

MOVEMENT / EXERCISE REGIME

  • IMPORTANT TO AVOID BENDING, TWISTING, PUSHING, STOOPING OR LIFTING anything you are not comfortable with, overall this is <2-3 kgs initially.

  • Get up from a lying position by first turning onto one side.

  • Initially limit sitting to an upright posture for 20-30mins at a time, 4 times per day (usually aligns with mealtimes). Avoid lying on the sofa, use the bed instead.

  • Once you are home: continue walking in the house then progress to outdoors.

  • Gradually increase the distance you are comfortable with.

  • Start at approximately 10-15 minutes 2-3 times per day, if you are up to it.

  • Build on what you have learnt in rehabilitation.

  • Gentle Core muscle strengthening can begin after the first two weeks.

  • You may be given a lumbar brace for use when out of bed over the first 8 weeks

    • This is not always used these days as people get moving quicker

  • If you feel increased soreness or discomfort- REST and let us know if ongoing

  • Resumption of sexual activity: generally this is over the first four to six weeks, being careful to avoid unusual strain or positioning.

  • By the fourth week try to walk 2-3 times per day for 20 mins each at a comfortable pace

DRIVING / GENERAL ADVICE

  • It is advisable not to drive from time of discharge until you are reviewed in the rooms at about 6 weeks post-op.

  • Alcohol intake is okay but should be limited to two glasses at any one sitting

  • Make all efforts to refrain from smoking as this definitely reduces the chance of successful healing and bone fusion by up to 30%

MEDICATIONS

On discharge you will be on some medications (apart from your regular ones)

  • Analgesics

    • This is usually paracetamol/codeine combinations, tramadol or oxycodone, you will find the doses can be gradually decreased over the first few weeks; others used may be endone or in association with long acting paracetamol. As a general rule take regular pain relief (eg every 4-6 hours) to avoid any pain rebound.

IF YOU EXPERIENCE ANY OF THE BELOW SYMPTOMS OR PROBLEMS, PLEASE NOTIFY YOUR SURGEON:

Procedure Related

  • Wound or wound care issues
  • Changes or new difficulty moving or controlling your legs or feet

General

  • Fever, chills
  • Cough, shortness of breath
  • Calf or ankle swelling
  • Pain passing urine

RETURN TO WORK

  • This should be delayed until you are reviewed in the rooms and feel well recovered.

  • Avoid the temptation to overdo things in the first 3 months.

  • Return to work is often graduated, sometime after the first 6-8 weeks. If you previously worked in a heavy manual labour type occupation, it may be much longer before you can consider more heavy lifting. Your surgeon will discuss your return to work plan with you.