General Rules for first 2 – 3 weeks after operation
- Start immediately with static abdominal and gluteal holds as follows:
- Lying prone (with or without a pillow under your waist) gently tighten your buttock muscles together and hold for 10 seconds, repeat 10 times
- Lying on your back with knees bent up – draw in your lower abdominals (using your pelvic floor muscles to help if necessary ). Hold 10 sec x 10. Repeat hourly. These are to recruit tone fibres into these important stabiliser muscles.
- Nerve mobilisation
Sit on the side of the bed with your back absolutely straight – straighten up one knee until nerve tensions. Then, in that position, pull your foot back and forth towards you 20 times only. Repeat maximum twice a day.
- No driving for 10 to 14 days
- No lifting for three weeks
- Housework should be light – no bedmaking, no hoovering, careful loading of dishwasher and washing machine
- Standing and walking – do so with your lower abdominals and gluteals “switched on ” to support your back.
You will be required to complete a pain diary for six weeks after operation and complete a questionnaire at six weeks. Then return both to the Foundation for clinical review and audit.
Postoperative Information for Minimally Invasive Lumbar Spine Surgery Patients
You will be given a course of anti-inflammatory drugs for two weeks on discharge. If you are having a flare then ask your GP for further prescriptions as necessary to control the symptoms.
You will have a dressing to a small wound on your back. Please leave this in place for 5 days. Please keep this dry. Cling film is a useful means of protecting the dressing. Shower rather than bath until the stitch is removed.
If you live at a distance, please arrange to visit your GP surgery for removal of sutures at seven days post operatively.
You will have either steri-strips or a suture to your wound. Steri- strips can be removed after five days by yourself. If you have a suture you should seek an appointment with your GP surgery a week after the operation to have the suture removed.
When taking a bath lie flat with knees bent.
Patients are warned that they may have a mild recurrence of their present symptoms immediately after surgery or more usually commencing at 5 days and increasing to peak at 10 – 14 days after surgery. This occurrence affects 10% of patients and is termed the post-op flare. This is a common occurrence but patients should contact Mr. Knight if they need reassurance.
Patients should wear sorbothane heel pads for at least three months.
After The 1st Week Following Your Operation You May Add The Following:
- Resume exercises – If you have already been taught these by your Physiotherapist pre-operatively.
- Bent knee fall out, heel touches, prone knee bends, prone hip rotations.
- If not – proceed to increase the strength of contraction and holding time of your abdominal and gluteal exercises until you start physiotherapy.
- Sitting – number of episodes may be increased but still limiting upright episodes to 20 minutes
- Walks- may be increased of comfortable- maintaining your abdominal and gluteal support as you do so
Those who have been taught pre-operatively by the Physiotherapist may resume the above exercises WITH CARE, after one week.
After The 2nd Week Following Your Operation You May:
- Return to a sedentary job
- Those involved in a light active job may return at three weeks following surgery and for those in heavy occupations return to work should be delayed until six weeks.
- Stop anti-inflammatory medication
- Patients may increase driving time preferably on quiet roads
- Return to work should be gradual in the first working week it should be delayed if the driving distance is >20 minutes, Try to avoid rush hour stop-start or difficult journeys
- Increase general every day activities
- No heavy lifting for three months from surgery
Once the spine is sufficiently stabilised, our aim is to increase your level of function to include activities such as static cycling, swimming, callenetics, light gym weights with the back stabilised. No jogging or rotatory sports such as squash / tennis / badminton / rugby until advised by the Physiotherapist.
Sexual intercourse may now be resumed making sure the back is in a comfortable position.
Rehabilitation will be progressed by the Physiotherapist.
Postoperative Information for Differential Discography Patients:
Patients will be walked as soon as possible after return from theatre, stairs will also be climbed, corridors will be walked. Results must be recorded on the pain diary. This will be repeated every 2 hours over the next eight hours to see if the original symptoms have subsided. The patient leaves hospital with the pain diary to be completed 3 times each day for 6 weeks at which point a review will be arranged to determine the results of the Differential Discography.
During This 6 Week Period:
The patient should continue to replicate the pre-operative activities and medication unchanged to demonstrate the effective change caused by the intervention with:
- Driving as usual
- Work as usual
- Normal household activities
- Normal sporting activities
- Heel inserts will be supplied and worn continuously
Patients should attend Physiotherapy for neuromuscular rehabilitation three weeks after the test procedure with clinical review after six weeks.
No backfriend. No MacKenzies. No MacKenzie driven books.