Spinal surgery: Caring for yourself at home

You have had major surgery to correct a curve or deformity in your spine. Most people go home within five days after the surgery. Here is some information to help you continue to heal at home.

Discharge Checklist

What kind of things can I do?

Once you go home, you will gradually increase your level of daily activities. For example, increasing the amount and distance of walking you do every day will decrease pain and improve your appetite. With regard to school, most patients return three or four weeks after the surgery. Some students go for half days at first and gradually increase the length of their school day. Your surgeon will let you know if they have any specific restrictions about returning to school.

For at least six months, do not fully bend over or twist your back, and do not take part in activities such as gymnastics, contact sports (football, basketball and hockey), skiing or bicycle riding. Your surgeon will tell you when it is safe to resume these activities. They will also tell you when you can start swimming.

Do not worry if you feel tired during the first few weeks after the surgery. Remember, it takes time to fully recover from major surgery. You may need to continue taking your iron supplement for about six weeks after the surgery.

Wound Care

In most cases, your dressing (or bandage) will be removed before you go home. You will have Steri-Strips on your back covering your spinal incision (wound). The Steri-Strips will eventually fall off on their own, or you can gently remove them 10 to 14 days after the surgery. Ask your doctor or nurse about your stitches before you go home. Most stitches are self-absorbing and do not have to be removed. Sometimes, staples are used instead of stitches. The staples can be removed 10 to 14 days after the surgery. Your family doctor can do this.

In most cases, you will not need a home nurse after discharge. Be sure to have a family member check your spinal wound once a day until it is healed. It is important to monitor your wound for signs of infection, which include swelling, tenderness, redness, the incision separating or increased, or the appearance of foul smelling fluid or pus. If any of these occur, it is important to notify your surgeon's office.

Bathing

You may start to take showers four or five days after the surgery. Do not worry if the Steri-Strips get wet. You may want to use soap on a rope so you will not be tempted to bend over to pick up the soap. We recommend that you do not bend down to sit in a bathtub. Your doctor will tell you when it is OK to take a tub bath.

Taking your pain medication at home

You will probably feel pain for the first few days while at home. However, the pain should lessen each day. The medication you are to take at home will be based on the pills or liquid that was working to relieve your pain while in the hospital. Generally, you will be given a prescription for a stronger pain medication called an opioid, such as morphine or oxycodone. It is likely that you were given acetaminophen while you were in the hospital. It is important to continue taking acetaminophen along with the stronger medication.

Taking pain medication regularly while at home will lessen the pain. After the first few days, take the stronger medicine only when you need it. Eventually, you will only need the acetaminophen. You should avoid taking any non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen or naproxen, for three months after the surgery. These medications will interfere with bone healing and fusion.

Eating and drinking after the operation

You may not eat well for a week or two after the surgery. Small meals and snacks every two to three hours will help you maintain a well-balanced diet. You should eat foods from each food group every day. These groups are milk and dairy products, vegetables and fruits, meats, fish and poultry, and breads and cereals.

You may be constipated because of the pain medication and lack of physical activity. However, eating a high fibre diet (one containing whole grain breads and cereals, fresh fruit, raw vegetables, etc.) and drinking plenty of water and juices will help prevent constipation. You will be given information about medications, such as stool softeners, laxatives, suppositories or enemas, which might become necessary to administer should your bowel movements become difficult or painful.

Wearing a brace after your operation

Your doctor will tell you if you need to wear a brace following the surgery. The brace may be casted in the operating room. You will be given plenty of instructions on how and when to wear the brace. When you return to the clinic, the doctor will tell you whether you will need to continue wearing the brace.

When will I see the doctor again?

Before you leave the hospital, you will receive information about your follow-up appointment with the surgeon. This appointment will be between six weeks and three months after the surgery. At this appointment, you will have the opportunity to ask the surgeon about increasing your level of physical activity.

Equipment/rehab needs at home

Generally, you will not require any special equipment, nursing care or physiotherapy while at home. In circumstances when any specific needs are necessary, we will advise and assist you with arranging whatever is required. Children with pre-existing physical disabilities may require transfer to a rehab centre post-operatively, which will be organized through the surgeon's office.

When to seek medical attention

On discharge you will be given phone numbers to call if you have any concerns while at home.

Call if you:

• have numbness or tingling in the arms or legs that does not stop with changing positions.
• have nausea and vomiting that lasts more than 24 hours.
• have a fever greater than 38°C.
• show signs of a wound infection.
• have pain that worsens over time or is not helped by the pain medicine.