| |
|
|
|
| Lumbar Spinal Surgery |
| Your Medical Evaluation |
An evaluation helps your doctor learn more about your low back problem. The evaluation includes a medical history and physical exam. Certain tests may also be done. After the evaluation, your doctor will talk with you about the diagnosis. Then you can work together on a treatment plan that's right for you.
|
| Medical History |
| Your doctor will ask questions about your health and any history of back problems. |
| Be sure to mention: |
| • |
Health problems you may have, such as high blood pressure, heart disease, or diabetes. |
| • |
Medications you take, including aspirin or ibuprofen. Also mention if you take herbal remedies or supplements. |
| • |
If you smoke. |
| • |
Whether back pain keeps you from doing things you like. Also mention if it makes you feel helpless or depressed. |
|
|
| Physical Exam |
|
| During a physical exam, your doctor may have you lie down for certain tests. |
Your doctor will check your spine in a variety of positions. This may include tests to check for pain, such as raising your leg. Other tests measure your strength, reflexes, and whether you have any numbness. |
|
|
| Diagnostic Tests |
| To help diagnose your spine problem, you may have tests including: |
| • |
Imaging tests, such as x-rays, an MW (magnetic resonance imaging), or a CT (computerized tomography) scan. These tests take pictures of bones, disks, and nerves.
|
| • |
Blood and urine tests.
|
| • |
Other imaging tests, such as a discogram, myelogram, or bone scan. Contrast dye is sometimes used for these tests. |
| • |
EMG (electromyograms) to look for muscle and nerve damage. |
|
|
|
|
| Nonsurgical Treatment |
To help reduce back pain, your doctor may first prescribe nonsurgical treatment. This often includes limiting certain activities and having physical therapy (PT). You may also be prescribed medication.
|
| Taking Care of Your Back |
|
| Learning how to bend properly can ease stress on your back. |
Making some changes in your daily activities can help your back feel better. Try these: |
| • |
Learn how to reduce stress on your back while doing things like bending or walking. |
| • |
Limit certain activities, such as lifting. |
| • |
Improve your posture while sleeping or getting out of bed. |
| • |
Use back supports, such as a lumbar roll, to relieve pain and keep the spine balanced. |
|
|
|
| Physical Therapy |
| Physical therapy can help low back problems. A PT program may include: |
| • |
Exercises, such as walking, to improve your strength and mobility. |
| • |
Education, to help you learn how to move without hurting your back. |
| • |
Treatments, such as ultrasound, massage, heat, or cold. These help reduce pain. |
| • |
Manual therapy, which helps improve movement of the spine. |
|
|
| Medication |
|
| Walking is one of several exercises you may be given during physical therapy. |
You may be prescribed medication to treat pain, muscle spasm, and inflammation. Some medications are injected into joints or into areas near disks and nerves. Others are taken in pill form. Talk with your doctor about how your medications work. Also be sure to take pills as often as you're told—not just when you have pain.
|
|
|
|
|
Surgical Treatment |
If other treatments aren't improving your quality of life, your doctor may recommend surgery. Plan ahead for both your surgery and recovery. Be sure to follow any instructions you are given. And talk to your doctor if you have questions about surgery or how the procedure will be done.
|
| Planning Ahead |
|
| Stop smoking before surgery. |
| Planning ahead will help make your recovery easier and safer. Try these tips: |
| • |
Stop smoking. Smoking makes it harder for bone to heal. Ask your doctor about quitting aids such as gum, patches, or medications. |
| • |
Talk with your doctor about managing blood loss. You may be able to donate your own blood ahead of time. Or, you could receive blood donated by another person. In some cases, a drug called epoetin alfa is given before surgery to help reduce the need for transfusion. |
| • |
Move household items you'll need after surgery. Place them between hip and shoulder level. This keeps you from needing to lift or bend. |
| • |
Arrange for rides. You may not be able to drive for a week or more after surgery. |
| • |
Get a pair of slip-on shoes with closed backs. Then, you won't have to bend to put on shoes. |
|
|
|
| Before Surgery |
| Don't eat or drink anything after midnight. This includes mints, gum, and water. |
| Follow your doctor's instructions to prepare for surgery. Also, be sure to: |
| • |
Stop taking aspirin and ibuprofen at least a week before surgery. Ask if you should stop taking other medications, herbal remedies, or supplements. |
| • |
Arrange for an adult family member or friend to drive you home. |
| • |
Don't eat or drink after midnight the night before your surgery. |
| • |
If you are told to take medication the day of surgery, swallow it with just a sip of water. |
|
|
| The Day of Surgery |
|
| The anesthesiologist will talk with you before surgery. |
Arrive at the hospital on time. Before surgery, your blood pressure and temperature will be taken. You'll be given an intravenous line (IV) to provide fluids. You may also get medication to help you relax. lust before surgery you'll be given anesthesia (medication to prevent pain). Local or regional anesthesia numbs just the surgical area. General anesthesia lets you "sleep" during the operation.
|
|
|
| Reaching Your Spine |
To operate on your spine, the surgeon will make an incision through your skin. The incision will be in your back (posterior approach), or in your abdomen (anterior approach). After surgery, the incision is closed with stitches or staples. |
| Posterior Approach |
|
| Possible posterior incision site |
Your surgeon reaches the spine through your back. In some cases, a microscope is used to view damaged areas more clearly. |
|
|
| Anterior Approach |
|
| Possible anterior incision site |
Your surgeon reaches the spine through your abdomen. This is done when your surgeon needs access to the front of your spine. |
|
|
|
|
|
|
| |
|
