When you wake up after your surgery, your back may feel sore and you will probably be attached to one or more tubes, including:
-an intravenous drip to make sure you do not get dehydrated
-a drain to take away any fluid from your wound
-a catheter, if you are having difficulty urinating
-a pump to deliver painkillers directly into your veins every few hours
The tubes are usually attached for only a short while after your operation.
Immediately after surgery, you will have some pain in and around the area of your operation. You will be given pain relief to make sure you are comfortable and to help you move. The original pain in the leg usually improves immediately, but if it doesn't, tell the nurses and your doctor. A very small number of people have difficulty passing urine after the operation. This is usually temporary, but in rare cases, complications such as nerve damage may cause the legs or bladder to stop working properly. It is important to tell your doctor and nurses immediately if you have problems. It can take up to six weeks to get over the general pain and tiredness after your operation.
You will have stitches to repair any cuts or incisions made during your operation. Deep stitches beneath the skin will dissolve and do not need removing. Stitches or clips used on your skin will be removed 5–10 days after your operation. You will be given an appointment to have your stitches removed before you leave hospital. Your stitches may be covered by a simple adhesive dressing, like a large plaster. When you wash, be careful not to get your dressing wet. After having your stitches out, you will not need a dressing and will be able to bath and shower as normal.
Your medical team will want you to get up and move about as soon as possible. This is because not moving can increase your risk of deep vein thrombosis and movement helps to speed up the recovery process. After your operation, a physiotherapist will monitor your specific needs and help you safely regain strength and movement. Exercising the spine as instructed will help you recover quicker than if you stay inactive.
You will be able to go home one to four days after your operation. How long you have to spend in hospital depends on the type of surgery you had (recovery is quicker after a microdiscectomy) and your state of health. It is important to take things easy at first. Some help at home is usually needed for at least the first week after surgery. Avoid heavy lifting, awkward twisting and leaning when you do everyday tasks.
When to seek medical advice:
Lumbar decompression surgery is generally safe with a low risk of complications, but they can sometimes occur. Contact your surgeon or doctor as soon as possible if:
-there is leaking fluid or redness at the site of your wound
-your stitches come out
-your dressing becomes soaked with blood
-you have a high temperature (fever) of 38C (100.4F) or above
-you have increasing pain or numbness in your legs, back or buttocks
-you cannot move your legs
-you cannot urinate or have lost control of your bladder
-you have a severe headache
-you have a sudden shortness of breath – this could be a sign of a blood clot inside your lung (pulmonary embolism), a lung infection (pneumonia) or other heart and lung problems.
When you can go back to work depends on how you heal after surgery and the type of job you do. Most people return after four to six weeks if their job is not too strenuous. If your job involves a lot of driving, lifting items that weigh over 5kg or potentially violent situations, you may be off work for up to 12 weeks.
Before starting to drive again, you should be free from the effects of any painkillers that may make you drowsy. You should be comfortable in the driving position and able to fully control your car, including being able to do an emergency stop without it causing you any pain. Most people feel ready to drive after two to six weeks, depending on the size of the operation. Some insurance companies do not insure drivers for a number of weeks after surgery, so check what your policy says before you start to drive.
After back surgery, 20%–30% of people experience recurring symptoms. These can be caused by a weakened spine or another slipped disc, formation of new bone or thickened ligament. Other treatments, such as physiotherapy, will be tried in the first instance, but further surgery may be needed in some cases.
Michael J. Olek, DO