Care after cervical spine surgery
What to Expect Following Cervical Spine Surgery
The majority of people who undergo cervical spine surgery experience good to excellent results following the operation. Most people will experience significant relief of pain both in the neck and the radicular pain into the shoulder and arm. The goal of the majority of cervical spine operations is the successful return to the activities of daily life.
A surgical procedure on the cervical spine can last from one to several hours. Spine fusions which require the placement of plates and screws tend to last much longer than simple discectomies. Patients often report improvements in the way they feel immediately after they awake after the surgery. However, strengthening the weakened muscles and soft tissue surrounding and supporting the neck requires a longer-term program of exercise and therapy. Although many patients see and feel immediate benefits, they need the benefits of a comprehensive rehabilitation program for several months to get the total benefit.
The type of cervical spine procedure that was performed will determine how long you will need to stay in the hospital and how much assistance you may need shortly after surgery. Many procedures on the cervical spine only require one or two nights in the hospital.
The day after surgery is considered day one. Under the supervision of a physical therapist you may sit on the edge of the bed and stand with support. You will most likely be wearing some type of cervical brace you return from surgery. You will need to keep this in place unless specifically instructed to remove it by your surgeon. While patients are often encouraged to stand and sit (with assistance if needed) within twenty-four hours after surgery, walking is approached gradually and in a guided manner to avoid injury and complications. Try not to over-do it the first few times you get up and walk.
Your nurse will check the circulation and motion of your legs and feet. You may have an Incentive Spirometer (blue inhalation tube) to help expand your lungs to prevent pneumonia. The dressing may be removed from your incision and the changed. Surgical tape, sutures, or adhesive tape will have been used to close your incision. An ice pack or cooling pad may be used to help decrease swelling and increase your comfort. Its common to continue intravenous fluids for the first day or two.
Your physical therapist will work with you to help you begin moving safely. Ideas will be given to help you move safely in bed and up to a sitting position. You’ll gradually progress to standing and walking. You may require the use of a walking aid (cane or walker) for a short time following surgery. Exercises may be given to ease soreness in your legs. You may begin static tightening of the thigh and buttocks muscles. Ankle pump exercises can help fluid from pooling in the lower limbs and prevent the formation of blood clots in the legs.
Your physician order your diet. Recovery from anesthesia varies from person to person, so your diet will be adjusted as your intestinal function returns to normal. Usually as soon as you are able to eat, you will be allowed to have clear liquids. If you are able to tolerate these, you will be given more solid food.
Antibiotics may be given intravenously for 24 hours to help prevent infection. Pain medication is available to ensure your comfort. During the first 24 hours after surgery, you will probably be given pain medications that are injected – either through the IV line or as intramuscular injections into the arm or buttock area. These medications are usually much stronger and faster acting than pills taken by mouth. If you are uncomfortable, please let your nurse know. It is important to have a level of comfort so you can participate in your exercise program.
Day Two and Beyond
If needed, your wound dressing will be changed or removed.
During the first few days after surgery, there is naturally some pain which should be expected. But it can be adequately controlled by medication. Please let your nurse know if you are in pain. After the first day, it will be important to begin the switch from pain medications that are given through the IV line to pills you can take by mouth. It is difficult to go home until you can take pain medications by mouth.
Your physical activity will continue to focus on your safety with mobility and helping you toward independence. In spite of any mild discomfort, its important that you do the deep breathing and physical therapy exercises as instructed. Patients who breathe well and work at tightening their muscles are able to better their lung capacity and circulation, and they often heal faster.
How to Use Your Neck Brace
You have been fitted before surgery with two different types of cervical collars. As soon as all your bandages have been removed and you feel strong enough after your surgery, you may shower wearing your Philadelphia collar made of foam. You may also shampoo your hair while in the shower as long as your collar is securely in place.
After your shower, towel dry as normal while keeping your Philadelphia collar on securely.
Then lie flat on your back with the second collar (the Miami J) by your side. Undo the velcro on the wet collar and remove the front portion of the wet collar while keeping your neck still. Wash your neck area with water and mild soap and pat dry. Have a family member or friend inspect your incision for signs and symptoms of infection (see your discharge sheet).
If you are alone you can use a hand held mirror to inspect your wound. Men may also shave while in this position.
Replace with the front portion of the dry collar. Holding the front portion firmly with one hand, log roll onto your side. Be careful to keep your neck still and remove the back portion of the wet collar. Wash, and pat dry the back of your neck. Replace with the back portion of the dry collar. Log roll onto your back and attach the velcro straps in place.
The Miami J (blue and white) is to be worn full-time until your first post-op visit with your doctor.
Do not use lotions, powders, or oils on your incision while it is in the healing process.
If skin irritation occurs try wearing a silk scarf under your brace. This can be very soothing and help decrease irritation.