After the Operation

What is the period of hospitalization?

This will vary according to your individual circumstances and medical condition, but most people are able to go home after about three to five days.

What can I expect in hospital after the operation?

You will probably be quite surprised at how quickly and easily you will be able to get moving after the operation. We will usually aim to get you up, standing and taking a few steps later the same day or the day after the operation. Hydrotherapy (pool based physiotherapy treatment) is available at the hospital and is a great way to gain confidence with movements and mobilization. Your wound will be protected by a waterproof dressing when you go in the pool. As your mobility improves you will be encouraged to take regular short walks. You will start a programme of core stability and other physiotherapy exercises, which are very important, and these will continue after you go home. Your therapist will show you ways to protect your back while doing everyday things such as getting in or out of bed, dressing, getting up out of a chair or getting into a car.

The nursing staff will work with you to try and ensure that any post-operative discomfort is kept to a minimum. Initially this may well be through the use of pain killing medication through a line which you control, as you require, through the simple press of a button (Patient Controlled Analgesia, or PCA), but quite quickly you will be able to switch to simple tablets.

To minimise the risk of a deep vein thrombosis (DVT), which is the formation of a blood clot in one of the deep veins in the leg, you will be provided with special elasticated stockings. When you are resting in bed you will be fitted with A-V impulse boots and we will ask you (and remind you) not to cross your legs and to do special foot exercises. All these measures help to reduce the chance of a thrombosis forming, as will walking which is another reason we encourage you to get up and start mobilising quite early.
Once you are comfortable and happy with your ability to get up and around you are about ready to go home. This is usually by about the second or third day after your operation. By this stage you will be safe to sit, walk and travel in a car for moderate periods.

Will I need a brace?

No, there is no need for a brace after spinal decompression.

What will my convalescence involve after leaving hospital?

The Surgical Wound
The dressing will be checked before you leave hospital and will be changed if necessary. It can be removed nine days after your operation.

Activity and Movement
You will need to continue with your programme of active home exercises and supervised physiotherapy after your discharge from hospital. This will usually involve attending the physiotherapy department about twice a week to start off with, either at the Nuffield Hospital Hampshire or locally to your home. Initially your physiotherapist may use treatments to help settle soreness and muscle spasm and bruising from the operation. Regular walks are also helpful. If your stenosis has been severe your legs may be weaker than normal and it may take some time for the strength to improve. You will be taught what to do to protect your back and how to position yourself when you sit or lie down. Quite soon you will move onto more active treatments to build up your strength and improve your flexibility. Endurance exercises such as treadmill walking and static cycling further help muscle strengthening.

Over the next few weeks you will find that you should be able to return to most normal day to day activities. This should be a gradual and progressive process, guided by how you feel and by the progress you make with your physiotherapist. Take care and don't try and be too ambitious. It's important to achieve good muscle control before you try and push your range of movements too far. Make sure you are happy with one stage in your programme before you try and move onto the next. As you gain confidence in your movements you can incorporate these in everyday tasks and activities, including bending

Driving and Travel
You can return to driving as soon as you feel reasonably confident about getting in and out of your car and happy that you will be able to sit comfortably for the necessary time. You shouldn't drive if your concentration is impaired, for example if you are uncomfortable, or if you are taking medication which might make you drowsy.

The same guidelines apply to airline travel. If you do plan to travel in the first few weeks after surgery take an aisle seat so you can get up for a stretch and do a little walking periodically, and wear you elasticated stockings. Keep yourself well hydrated and consider taking half an aspirin a day, starting a few days before your trip. These measures help to reduce the risk of DVT.

Sports and Fitness Training
You will probably be able to return to light aerobic fitness training at your health club by about three or four weeks after your surgery. You can discuss appropriate exercise with your physiotherapist. It is best to wait until about two months before returning to golf and competitive sports.

Return to Work
You will be able to consider returning to light semi-sedentary work in two to three weeks but if your work is more physically demanding you may benefit from a longer period of recovery. In the weeks after an operation you will tend to tire more easily and may be better to return on a part time basis initially.

What to expect in terms of symptoms after your surgery

Although you will recover quite quickly from the surgery, you are certainly likely to be aware of some discomfort and soreness deep in your back. The wound itself will feel a little sore. These problems will gradually improve over the days and weeks following your operation.

It is not unusual to experience some leg pain after your surgery. This may be due to some residual inflammation or bruising of the nerve roots. Similarly, some 'rebound pain' may arise as the nerve roots recover, sometimes a few weeks after the surgery. Don't panic if you experience this; it is quite common. However, if you are worried, or if your leg pain is getting worse, please contact the ward or Mr Boeree's office.

The symptoms that you experienced before your surgery won't necessarily settle immediately. Recovery may be quick or slow and sometimes is incomplete. Persevere with your exercises and be prepared to give these symptoms some time to improve.

Medical Follow-Up

When you leave hospital we will contact your doctor to ensure he or she is fully aware of the operation you have had any necessary care needs you may have. You will be sent an appointment to be seen by Mr Boeree at six weeks after your operation. Your physiotherapist will, in the meantime, have kept Mr Boeree informed about your progress. During this time if you have any concerns please feel free to contact Mr Boeree's office, although it is often worth discussing these first with your physiotherapist or GP.

 

 

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