Recovery after lumbar spine surgery

11.10.2021

Now there are quite a few methods of treatment of intervertebral hernia without surgery. But still, in some cases, it is impossible to do without surgical intervention, in this case, the question of how rehabilitation should be carried out after removal of the intervertebral hernia is particularly acute. It depends on how correctly this stage of treatment is organized whether the disease recurs and whether new hernias or protrusions appear.

Many people believe that the best way to recover from hernia surgery is to rest and limit stress. In this case, medicines and the regimen prescribed by the doctor are often ignored, since the pain has already left the spine, only a slight pain remains at the incision site, which is quite simply removed with conventional painkillers. In fact, such a “method” of recovery is almost a direct path to a new hernia, since the muscular corset of the back only weakens without exertion, blood circulation in the affected area is poorly restored, and the intervertebral discs still do not receive the substances they need. Of course, each patient has his own rehabilitation course, but there are “basic” principles on which recovery after surgery is based, which we will discuss further.

What are the types of hernia surgery?

Nowadays, hernia removal methods are developing in the direction of minimizing the surgical trauma as much as possible. That is why classical laminectomy is used less and less, and preference is given to endoscopic methods and microsurgical removal of hernias. It is these methods that involve minimal surgical trauma, due to which the recovery of the patient is faster.

At the same time, it is worth remembering that endoscopy is considered a very promising method, but at the moment it has a number of weaknesses. For example, the location and size of a herniated disc may be such that the endoscope simply cannot "reach" it.

A microsurgical operation performed under a microscope is, in fact, neurosurgery. At the same time, the surgical injury is slightly more than with endoscopy, but there are no restrictions on the position and size of the removed hernia in this case.

What happens immediately after the operation?

Many believe that the operation ends the treatment. In fact, this is not at all the case. Even after the operation, various pain and neurological symptoms, sensory disturbances, etc. may persist for some time. This is due to the fact that the pressure of the hernia on the nerve endings has disappeared, but the irritation and swelling have persisted. It is not so difficult to cope with this problem, but some medical treatment is still necessary.

Therefore, usually rehabilitation after surgery is carried out in three stages:

elimination of pain syndromes and neurological symptoms;
stabilization of the patient's state of health and elimination of household restrictions;
restoration of the strength and integrity of the musculoskeletal system, removal of restrictions on physical activity.

What will be the set of specific actions depends immediately on a number of factors. This takes into account the course of the disease, and the individual characteristics of the organism, and the timing of conservative treatment. In general, the rehabilitation phase can take up to a year, depending on how difficult the operation was. Although even in the best cases, rehabilitation can hardly be less than three months.

In the usual case, rehabilitation includes drug treatments, physiotherapy, mechanical unloading of the spine, therapeutic exercises, as well as spa treatment.

However, there are some restrictions and rules that the patient must comply with. For example, you need to remember that rigid corsets, which are designed to relieve the load on the affected spine, cannot be worn all day long, they can only be used for a few hours a day. Otherwise, you risk getting additional harm instead of a healing effect.

Therapeutic physical education is generally the basis of the entire rehabilitation process, so it should not be forgotten at all. It is necessary to regularly perform the exercises prescribed by the doctor, only in this case the exercise therapy complex prescribed by the doctor will bring you to the optimal state as quickly as possible.

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Rehabilitation after surgery to remove an intervertebral hernia (video)

Intensive recovery phase

Rehabilitation is aimed during this period at the adaptation of the operated patient to everyday life. It lasts for different patients from 3 months to a year. During this time, inflammation subsides, the scar heals and motor activity gradually returns.

Buy a corset for the back in specialized stores. It will take the pressure off your back. But just don't wear it all the time.

limit the duration of being in one forced position;
small physical activity is allowed after warming up the muscles;
exclude or limit travel by public transport;
do not lift weights;
protect the operation site from hypothermia;
a corset for the lumbar, thoracic region to wear for a limited time;
give periodic rest to the spine.

Postoperative hernia at a late stage does not require treatment in a hospital. Rehabilitation includes:

Drug treatment to eliminate inflammatory processes, pain relief, bone tissue restoration.
Physiotherapy procedures to improve blood flow, pain relief.
Therapeutic exercise. Complexes for the lumbar, thoracic or cervical region are significantly different.
Kinesiotherapy, hydroprocedures that unload the spine.
Recovery in sanatoriums or rehabilitation centers.

Late period

The most important moment of treatment is the rehabilitation period. Treat this with reverent attention and your health will answer you with gratitude!

After restoration of working capacity, a delayed stage begins, which lasts a lifetime. Under the supervision of physicians, the restoration of the muscular corset is underway. Muscle strengthening exercises become more active. Manual therapy and massage are added to the main methods of recovery. The procedures are aimed at improving blood flow, returning the patient to normal life, and preventing the appearance of a new intervertebral hernia.

In the late period, doctors advise:

do not lift weights more than 5 kg;
avoid prolonged sitting or being in an upright position;
in no case do not jump, do not make sudden movements;
avoid hypothermia, use a warm scarf for the lumbar region;
refuse to wear a corset for a long time;
strengthen the muscular corset;
follow the recommendations for nutrition, rest, activity.

Rehabilitation methods

There are many ways to recover after surgery. Only a doctor can competently draw up a program, taking into account the characteristics of the disease, individual abilities, and the patient's condition.

Medical treatment

Be sure to take all the medicines prescribed by the doctor at the indicated time, only a systematic approach leads to a cure for the disease

After the operation, all patients receive anti-inflammatory, analgesic drugs to relieve inflammation of the spinal nerves, reduce tissue swelling, and relieve pain.

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When conservative treatment fails, then spinal surgery can help. Acute lesions of the spinal cord occur due to a hernia that has formed in the cervical, thoracic or lumbar region. When severe consequences appear, such as paralysis, urinary retention, and others, then the operation cannot be avoided. It is also required to operate on a person who has an epidural abscess, a complex hematoma, due to which the spinal cord is compressed. As soon as paralysis appears, a person needs an urgent operation, otherwise he may stay with him forever. Surgeons are trying to eliminate the compression of the spinal cord, as well as its roots, and stabilize the segment that has suffered damage.

Operations are also performed for scoliosis, but only in this case complications may appear. This has to be inclined mainly to those people who have a severe stage of the development of the disease, and the deformation is more than 40 degrees. If this is not done, then the violation of the work of vital organs, such as the lungs and heart, will begin.

Preparing for the operation

Before starting the operation, a person should undergo a little preparation. From the very beginning, he will need:

take general blood and urine tests;
undergo spine tests, such as an MRI;
be examined by an anesthesiologist.

The doctor is obliged to clarify whether the patient has allergic reactions, chronic diseases, since all these factors are taken into account before starting surgery. A person should not eat food 8 hours before the start of the procedure.

The anesthesiologist determines the method of anesthesia, he takes into account the state of health. When the work takes place on the cervical spine, then general anesthesia is used. It is also used in the presence of severe pain, when it is difficult for the patient to be in one position. But in most cases, local anesthesia is used.

When implants are installed, an antibiotic is first administered intravenously. Different methods are used for the operation, the main thing is that it is performed by a qualified doctor.

Surgery for scoliosis

Scoliosis is treated in different ways, but if all methods slowly help, and the pathology interferes with the normal functioning of the internal organs, then surgical intervention is used. In addition, often a consequence of scoliosis can be a defect in appearance, which can be eliminated through surgery. After the procedure is completed, the patient should do gymnastics, which will help strengthen the body.

In childhood, it is not always possible to apply surgical intervention. The operation is performed only when the spinal column has already completed its growth. Otherwise, surgeons can cause the reverse process, when the spine begins to deform.

When the pain does not disappear, no methods help anymore, then surgical treatment is chosen. It depends on the situation how long a person will be rehabilitated after such a procedure. Some people need a couple of weeks, and some bring the body back to normal for several months.

Scoliosis correction

To date, there are various kinds of operations that can correct the spine when scoliosis is observed. There are some of the most popular techniques.

Harrington method. She uses metal structures, namely hooks, rods. During the operation, they are attached to the spinal column in the right places. After such a surgical intervention, experts advise wearing a corset in order to restore the body a little.
Cottrell-Dubousset technique. In this case, an implant is used. It contains hooks and rods.
Luke's method. It uses an L-shaped design.

In addition to these methods, others are used. Depending on how complicated the situation was, what technique was used, rehabilitation will be delayed.

The danger of hernia surgery

Of course, conservative treatment is much safer, because the operation always carries a risk. But sometimes it is simply impossible to do without surgical intervention. After all, a hernia between the vertebrae can torment for a long time, and no methods can cure it because of its complicated nature. In order to regain a normal life, a person is inclined to carry out the operation, as it is necessary for him.

There are such indications:

the functions of the pelvis were disturbed, constipation appeared;
urination is very frequent;
changes in brain function;
changes in the work of the heart.

If the operation will be carried out by a good specialist, then you should not worry. Although surgery in any case carries a risk.

Consequences after hernia removal

Each patient should be aware of the consequences that may appear after the operation. Basically, this procedure takes place without sad consequences, the effect pleases the patient.

Sometimes inflammation can begin in the place where the intervention was performed by surgeons. To prevent this from happening, the patient is prescribed antibiotics, which remove the risk of such a consequence.

There are also situations when, after the operation, the hernia reappeared after some time. This is called a relapse. This effect depends on the recovery period. It can be concluded that it went wrong.

Sometimes complications can cause cicatricial process. It can begin to infringe on the nerve root of the spinal cord.

When a hernia is removed, the result may be a displacement of the vertebrae, from which the curvature of the spine changes. But such an occurrence is very rare. To avoid such consequences, the operation must be carried out by a good doctor.

Rehabilitation

After the operation, a person needs to restore his body. There is rehabilitation, which includes various procedures that can improve the condition.

exercise therapy

Without fail, a person who has survived the operation is required to do physiotherapy exercises. It helps to rehabilitate after various surgical interventions. This is a very efficient method. There is a huge selection of exercises, so it is better to consult a doctor who will select an individual exercise therapy complex. Subsequently, the pain syndrome will decrease significantly, the muscles will return their tone, and metabolic processes will return to normal.

Mechanotherapy

Mechanotherapy provides a list of different exercises that are performed using simulators or special devices. As a result, the joints become mobile, and rehabilitation is much faster. It is imperative to denounce mechanotherapy with a physician before engaging in it.

Massotherapy

Many rehabilitation procedures do not pass without massage. Indeed, it can have a beneficial effect on the body. There are different types of massage. Namely:

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Principles of rehabilitation after removal of an intervertebral hernia

Surgical intervention for intervertebral hernia does not mean that a person in a few days will feel healthy, mobile and ready to do any work. Rehabilitation after spinal hernia surgery lasts up to several months, and the full restoration of functions lost during the illness depends not only on the professionalism of the doctor, but also on the patience and perseverance of the patient. During the recovery period, the patient must follow all the recommendations of the doctor, their observance will prevent a possible relapse and will allow you to quickly cope with the restriction of mobility.

Conventionally, the entire rehabilitation period can be divided into three stages of different duration:

The first stage begins immediately from the moment the operation is completed and provides for the elimination of pain syndromes and neurological disorders.
The second stage is the adaptation of a person to everyday life.
The third stage includes a set of measures necessary to restore the mobility of the spinal column and aimed at preventing the recurrence of hernias. It is important during this period to choose a set of therapeutic exercises aimed at strengthening the muscular corset.

Early recovery period

The early rehabilitation period is up to two weeks after a surgical or other type of intervention on the spine. During this period, the postoperative suture heals, the lost sensitivity is restored and the pain decreases. Not all patients experience pain and restriction of movement completely immediately after surgery - swelling and inflammation of nerve fibers and tissues disappear within a few days, after this period it will be possible to evaluate the results of surgical intervention.

In the early rehabilitation period, non-steroidal anti-inflammatory and analgesic drugs are prescribed. Patients with depressive states are shown the appointment of sedatives. Neurosurgeons do not advise staying in bed for a long time after surgery, in a day or two you can already perform simple movements and move around, the only condition for this is the use of a corset.

Orthopedic corsets will be required not only in the first days and hours after the operation, but also for several months, that is, during the recovery period when performing physical work or exercise. Rigid bandages prevent displacement of the vertebrae, prevent sudden movements, and promote rapid healing of internal and external sutures.

In the early rehabilitation period, the doctor evaluates the appearance of sensitivity in the extremities, the restoration of the function of the pelvic organs, prescribes tests and repeated shots. The choice of drug treatment will depend on the data obtained and the patient's well-being.

Rehabilitation of the patient after discharge from the hospital

Depending on the type of surgery, the general well-being of the patient, the presence of complications, discharge home can be made on the third or tenth day after the operation. Before discharge, the doctor must give the operated patient detailed and complete recommendations, the observance of which depends on the restoration of health and all functions of the spinal column in the future.

Rehabilitation after removal of an intervertebral hernia is carried out by any patient with the obligatory observance of the following conditions:

For a month and a half, you can not sit, this will avoid the re-formation of a hernia and pinching of the nerve roots.
It is necessary to avoid sharp inclinations, turns, twisting of the torso, jumps and strikes.
About three months of travel in cars or other vehicles are allowed only in a reclining position. It is advisable to wear a corset during such a movement.
Do not lift heavy objects. Within a month after the operation, it is no more than two kilograms in both hands, in the future the weight is increased. For the first six months, the maximum weight in one hand does not exceed three kilograms, while the load is distributed evenly.
It is unacceptable to tense the muscles of one half of the body while relaxing the other. Therefore, it is advisable to carry all kinds of weights in a backpack behind your back, which ensures even distribution.
Every hour and a half it is recommended to give rest to the spine, for this they move from a vertical position to a horizontal one.

During the first weeks after the operation, the postoperative scar heals, the impaired sensitivity of the nerve endings is restored, and the processes of restoring the functions of the spine take place. Therefore, the task of the patient at this stage is to create the most favorable conditions for his spine. Active recovery of the spine after surgery is started in about a month, rehabilitation measures include:

Therapeutic exercise.
Physiotherapy.
Spa treatment.

Restorative gymnastics in the early stages is carried out only under the supervision of a specialist, various sudden movements can lead to an attack of pain. Rehabilitation after removal of a hernia of the spine, in addition to exercise therapy and physiotherapy, may also include classes on special simulators, therapeutic massage, and reflexology.

Therapeutic exercise in the postoperative period

Physiotherapy exercises are necessary throughout the entire period of recovery of the body after surgery and in later life. Physical exercises increase joint mobility, strengthen the muscular corset, increase blood supply, nutrition of the spinal region, and help to remove toxins accumulated in the skin and muscles. The doctor is obliged to choose exercises and explain to the patient all the principles of gymnastics during the rehabilitation period.

You can start extended exercise about a month after surgery, but warm-up movements for the limbs and joints can be practiced already on the second or third day after discectomy. The simplest exercises after surgery include:

Circular movements performed by the hands and feet.
Flexion and extension of the elbow and knee joints.
Slowly pulling the knees to the stomach. In the early days, do not strongly stretch the spine in an effort to fully pull the knees to the chest.

General recommendations and rules have been developed for patients who underwent surgery for the removal of an intervertebral hernia. Their observance allows you not to experience discomfort and pain and to have the maximum beneficial effect on the spine.

During the exercises, sharp turns, inclinations are avoided, all elements are performed slowly and smoothly.
They begin to perform exercises with one or two approaches, gradually their number is brought up to ten at a time. A set of exercises is performed in the evening and morning hours.
If there is persistent pain or discomfort, you should consult with your doctor about changing the set of classes.

The exercises below are indicated for postoperative patients, but it must always be remembered that a rehabilitation doctor will be able to draw up a training plan correctly based on the patient's well-being, the presence of contraindications and the anatomical features of the spine of a particular patient.

It is necessary to lie on your back, bent knees gradually bring them closer to the chest. At the same time, tension is created in the muscles of the buttocks, then a period of relaxation and a slow return of the legs to their original position.
The position is also lying on your back, legs bent, arms spread apart. The pelvis is raised above the floor and held for the first time up to 10 seconds, in the future, the duration of the execution time gradually increases.
The next exercise includes a whole range of elements performed from one position. They are conveniently located with their backs on a hard surface, the hands are brought under the head, the legs are bent, the feet are on the floor. Movements are performed with the pelvis up and down, to the right and left side, then tilting the knees to the right - to the left and “bicycle” with the legs. At the end of the exercises, it is necessary to pump the abdominal muscles without lifting the lower back from the floor.
From a prone position, push-ups are performed from the floor, swinging the legs to the sides and up. The “cobra” body position is recommended - while inhaling, leaning on the elbows, it is necessary to bend as much as possible and stay in this position for 6 seconds, while exhaling, slowly return to the starting position. "Cobra" is performed up to 10 times.
Exercise "stand" helps to strengthen the muscular frame of the back and abdominal wall and stretch the spine. It is performed against the wall of the room, on which the protruding points of the torso, head and legs are supported. Hands rise up and in this position you need to stand up to 5 minutes. As you recover, the time increases, and the exercise is complicated by lifting on tiptoe.

Physiotherapy exercises will bring undoubted benefits after surgery and will prevent the recurrence of a hernia after surgery if the patient performs exercises constantly, moderately increasing the load. Throughout life, the patient is recommended to perform three basic sets of exercises - push-ups, squats and a bicycle. Allocating 10 minutes in the morning for exercise will allow you to transfer all daytime stress without discomfort and pain.

Therapeutic measures aimed at recovery

The sets of exercises selected by the doctor must be performed for 6 months or more, it is believed that during this time a callus forms at the site of hernia removal. After this period, physical therapy is expanded by training on simulators, massage, physiotherapy, mechanotherapy.

Mechanotherapy is the use of various simulators, with the help of which the physical conditions of influence on the limbs and spine are expanded. In patients with various paresis and paralysis of the limbs, a verticalizer can be used to give the body a vertical position - a device designed to prevent complications that develop with a long prone position.

The patient in the verticalizer improves the work of the cardiac, respiratory and urinary systems. Several types of verticalizers are produced, in some of them the patient can train the lower limbs, in others the back muscles, and others are equipped with a device for independent movement.

Therapeutic massage is recommended to be performed a few weeks after the operation. A professionally performed massage relieves tension, swelling, and prevents muscle atrophy. There are several massage techniques, their choice depends on the general health of the patient and the nature of the surgical intervention.

The use of physical methods of influence - ultrasound, laser, magnetic fields, electrical impulses enhances blood supply, nutrition and metabolism in the spine.

During the rehabilitation period, important importance is given to the diet after the hernia removal operation. Nutrition should be aimed at preventing constipation and gas formation, which can create an excessive load on the operated area. It is recommended to eat often, but in small portions, the daily menu should contain dishes with vegetable fibers and a sufficient amount of liquids - jelly, compotes, rosehip broth.

In the first days after the operation, they mainly eat vegetable and milk soups, liquid cereals, then the food is expanded by omelettes, steam dishes from vegetables, meatballs, meatballs, boiled fish. In the future, it is necessary to minimize products with cocoa, coffee, alcohol. You constantly need to monitor your weight - excess kilograms create an unnecessary load on the spine, which is categorically not recommended after the removal of intervertebral discs.

An intervertebral hernia can cause a lot of suffering to a person, so a successful surgical intervention cannot but rejoice. To maintain the positive effect of the operation and prevent the occurrence of complications and relapses, you can follow the following recommendations.

Rehabilitation after spinal surgery with a hernia lasts at least six months. During this recovery period, it is necessary to follow all the recommendations of the attending physician - restriction of movements, minimal weight lifting, refusal to drive a car and travel by transport.

Therapeutic gymnastics is an effective means of restoring the spine. Patients with an intervertebral hernia will have to engage in muscle strengthening throughout their lives.
Compliance with the diet in the first days after the operation and subsequently to prevent the appearance of extra pounds.
Regularly it is necessary to undergo preventive treatment, consisting of medications, physiotherapy, massage courses, vitamins and reflexology.
In the first weeks after surgery, it is necessary to wear an orthopedic corset, but not more than six hours a day.
Jumps, bumps, sudden movements should be avoided.
Swimming in the pools, skiing and cycling are shown.
It is necessary to avoid hypothermia and treat respiratory infections in time.

Compliance with all the measures proposed by the doctor to restore the body will allow you to lead a normal life, not limit yourself in doing your usual work and prevent the development of relapses.

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