Spinecare Topics
Benefits and Risks of Back Surgery
Recovery after Spinal Fusion:
The discomfort following surgical spinal fusion surgery is generally more intense than pain experienced with back surgery that does not require fusion. The hospital stay is generally longer and averages four to seven days. An attending physician will provide medication to help reduce and manage post-operative pain. Steroidal medication may not be offered because it can slow the bone fusion process.
It can take a relatively long time to return to an active lifestyle after spinal fusion. Prior to returning to normal activities, the attending spine surgeon will want to see radiographic evidence of proper bone fusion and healing. This is often not evident for six to eight weeks after surgery. Substantial bone healing usually does not take place for three to four months after a bone graft is performed. During this time, the attending spine physician will recommend activity modification and restrictions. A brace or corset is often prescribed by the surgeon to add spinal support during the healing process. The patient is instructed about weight-bearing positions that promote a stronger bone graft. A post-operative spine rehabilitation program is often recommended to reduce the risk of deconditioning, to strengthen muscles and place an adequate amount of stress on the fusion site to promote strong bone healing. A rehabilitation program will include back strengthening exercises and cardiovascular conditioning.
The healing process following surgical fusion of the spine may continue for one to three years after the surgery is performed. The degree and pattern of recovery depends on the severity of the preoperative problem, the efficiency of bone healing, and the degree of neurological compromise. Surgical outcome is more favorable when the patient is motivated to participate in a rehabilitative program, and perform necessary exercises long after they are released from a supervised program.
A spinal fusion does not return the spine to normal. It renders the fused spinal segment unable to move. This places additional stress on the adjacent spinal segments. Subsequently, a spinal fusion is not a quick fix and it is certainly not curative. Surgeons have to be careful that their patients have a realistic expectation of postoperative outcome.
Potential Complications of Spine Surgery
All surgical procedures can result in complications. Despite continued advances in medical science, the complications of spine surgery have not been eliminated. Surgical complications can be classified into two primary categories, which are 1) those which are directly related to surgery; and 2) those which are indirectly related to surgery. The indirect complications refer to medical problems that develop after surgical intervention. Direct complications occur more frequently than indirect ones. The type and rate of complications will vary with the procedure, the patient’s age, patient selection criteria, the surgeon and the facility where the surgery is performed. Complication rates are also dependent upon the patients' pre-existing medical conditions, the surgical selection criteria, the patient’s psychological health and social history.
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