Q: When will I go into hospital for my operation?
A: Most patients are admitted on the day of surgery. Some patients may be admitted on the evening prior to surgery. The admission office will inform you of the exact time to arrive at hospital for your operation and when to stop eating and drinking.
Q: How long will I be in hospital following my surgery?
A: Following minimally invasive or keyhole spine surgery, many patients go home the morning after the operation.
Elderly patients, or patients with severe symptoms or with spinal cord or nerve root compression, may remain in hospital for three to five days.
Patients undergoing spine fusion operations may be in hospital for up to seven days.
While there is a trend for early discharge from hospital to relieve the pressure on hospital beds, in most cases following spine surgery and minimally invasive spine surgery it is important to rest in the first one to two weeks after surgery.
This is often best done in hospital with nursing, physiotherapy and occupational therapy support services.
The exact timing of discharge is determined by each patient’s individual circumstances.
Q: How long should the wound remain covered after surgery?
A: For five days after surgery, dressings should be changed every 24-48 hours. It is important not to leave a dressing that is wet on the wound.
Dressings can be soaked off in the shower. The wound should then be allowed to dry before a clean, dry dressing is applied.
Q: When can I drive after surgery?
A: It is advisable to avoid driving for two weeks after your operation.
Q: When will I be seen for follow up?
A: All patients are generally seen for follow up six weeks to eight weeks after surgery. Patients with instrumentation or spine fusions should have an x-ray prior to the six week assessment.
Q: What exercises should I do in the first six weeks?
A: Avoid strenuous exercise such as swimming, weight training, cycling and running.
Walking, in increasing increments, to reach a goal distance of one to two kilometres per day is all that is required for the first six weeks.
Stationary cycling, hydrotherapy and walking in a swimming pool are fine from two to six weeks after surgery. You can recommence your normal exercise program following your six-week review with Dr Steel.
Specific exercises programs should be discussed with Dr Steel.
Q: Do I need to wear a brace or collar after surgery?
A: No. It is unusual to require collars or other prosthetic supports following surgery.
Q: Will I need to take analgesic medication?
A: A small amount of local wound discomfort is normal after surgery. You can use anti-inflammatory drugs such as Celebrex, Nurofen or Voltaren and mild analgesics such as Digesic and Panadeine.
Q: What sort of anaesthetic will I have at the time of surgery?
A: Virtually all neurosurgery is performed with a general anaesthetic. Occasionally, peripheral nerve surgery is performed with sedation and local anaesthetic.
Q: What if I develop a clot in the leg (DVT)?
A: The risk of developing a clot in the leg (i.e. a venous thrombosis) is very low after elective spine surgery.
Patients who remain immobile for a prolonged period after surgery are at increased risk of developing a DVT. This is why early mobilisation after spine surgery is recommended.
Dr Steel encourages mobilisation in the first few days after your procedure, usually with the aid of physiotherapists or nursing staff.
For patients with a previous history of venous thrombosis or with genetic predispositions to DVT – such as Factor Five Leiden – active prophylaxis DVTs with calf compressors, low molecular weight Heparin, Heparin or anti-thrombotic stockings are used to minimise the chance of further clots.
For patients who have difficulty mobilising, surveillance Doppler ultrasound scans of the lower legs are used as part of post-operative treatment to ensure early detection of any clot formation.
If a clot develops, it can be monitored if it’s small, or treated with anticoagulants such as Clexane or Warfarin.
Warfarin is usually continued for three months. This is supervised by a vascular physician