The following is a list of instructions for your convalescence, following your lumbar surgery.
This includes lumbar microdiscectomies, lumbar laminectomies, and lumbar spinal fusions.
These represent general instructions to be used as guidelines. They may be modified for an individual patient.
- No lifting, pushing, or pulling of heavy objects over 10-15 pounds, and no strenuous activity.
- When bending to lift an object off the floor, bend at the knees and NOT at the waist.
- Hold on to the back of a chair when bending.
- Do not twist the spine in any way.
- In order to avoid twisting your spine in bed a night, use a pillow between your legs and pillows at your sides to avoid rolling over onto your stomach.
- Use a straight back chair or a fairly rigid recliner for sitting.
- Do not use low or soft cushioned chairs for sitting, as they offer very little support.
- Use a lumbar roll (low back support cushion) when sitting.
- In the first 10 days to 2 weeks, do not sit more than 45 minutes to one (1) hour at any one time. Over the next six weeks gradually increase the duration and frequency that is comfortable for you.
- No back exercises will be done in the first 3-4 weeks. As you progress it will be determined by your surgeon when you can start an exercise program or physiotherapy.
- Return to work, your surgeon will tell you when you can. It usually occurs between the 3rd and 4th week with increasing work hours.
- Walking is the best activity to improve your overall fitness and endurance. This is started very early on following your surgery. You can begin with short trips and increase your time and distance. Begin with 10 minutes and slowly progress to walking 20-30 minutes 3/4 times a day.
- You may climb stairs from the very beginning, but start slowly and use the handrail. It may be advisable the first day or two, to have someone do the stairs with you to ensure stability and that you are comfortable.
- In most cases, dissolvable sutures have been used for your incision. The incision is covered with steri-strips and gauze dressing that protects the wound. The dressing is usually a water resistant dressing.
You may shower at home after surgery. The water resistant dressing will keep the wound dry. Before you are discharged the nurse will provide you with further instructions regarding the care of your wound.
Do not take a bath for at least three (3) weeks after surgery.
- If staples have been used, you will need to be seen within 7 - 10 days from surgery at the office to have the staples removed.
- You are not to drive for the first 10 days to 2 weeks following surgery. You can ride in a car for short distances up to 20 minutes after the first week. Generally you can drive to the office for your first office visit. Prolonged sitting in a car may exacerbate back or leg symptoms that were present pre-operatively.
- You should rest between activities. You will tire more easily for the first few months post-operatively. It can take a while for your energy level to return to normal. It is generally a good idea to get up every morning, bathe, get dressed and resume a normal routine.
- For Patients Having a Lumbar Fusion... In addition to the soft tissue that must heal following the surgery, we are also waiting for the bone to mesh together to form a solid fusion. During this time you should be careful when bending and twisting your back. A brace may be used to support your back and this may be a lumbosacral corset or a rigid brace.
- Medications may include pain relievers and analgesics to control pain, although they may cause drowsiness and constipation. They may also be habit forming and you may want to consider the amount of pain medication you are taking. You may also consider taking multivitamins with iron on a daily basis for a few weeks post-operatively. This may also make you constipated, so you should consider taking a stool softener. You can also take oral calcium supplements up to 1000 mg. per day which can also be helpful for a fusion.
- Formal physiotherapy, abdominal exercises and strengthening programs will be started when it appears healing is well underway. It also coincides with weaning off the brace for patients with a fusion.
- Each individual situation is different and therefore requires individualized attention. Feel free to ask questions during our office visits. Write down your questions before you come into the office so you don’t forget anything.
- CAUTION to all spinal fusion patients: It is well known that smoking severely slows down the healing process for all patients with low back surgery. Nicotine can adversely affect the rate of fusion and recurrent disc herniation.