Spinal surgery is for those whose severe back pain has not responded to more conservative treatment methods after at least 3-6 months. The back pain must have an identifiable source such as a pinched nerve or a painful motion segment. Spinal fusion may also be done if you have fractures or injuries to the bones in the spine, a weak or unstable spine for various reasons (including normal aging), abnormal curvatures, or arthritis in the spine (spinal stenosis).
Candidates who have severe back pain without an identifiable cause would not be helped by spinal surgery. Candidates who have yet to try more conservative treatment methods such as physical therapy, chiropractics, epidural injections and medication should try more conservative treatment before deciding upon lumbar decompression surgery.
Like other surgeries, spinal surgery requires a complete physical examination with your primary care provider and/or orthopedic surgeon before surgery. You should inform your orthopedic surgeon of any medications or supplements you take, and comply with certain general surgery procedures such as preoperative blood testing and possible cessation of smoking or use of pain relievers and anti-inflammatory drugs one week prior. You may need to stop taking blood thinner medication (such as Warfarin). You will likely be asked to stop eating or drinking the night before the surgery.
Preparing your home for recovery is also important. Look into getting assistance, either from friends and family or via paid home assistant services. Bending should be avoided at all costs, and your home should be rearranged to reflect this, from buying a metal claw grabber to avoid contorting your spine to other smaller adjustments.
The first few days after your procedure will be spent at the hospital, and you will likely have a urinary catheter inserted. You will be discharged home with a back brace or cast, and should follow your doctor’s instructions with regards to general activity level and level of assistance required. Ensure your incisions are kept clean and dry. Follow your surgeon’s instructions in regards to bathing, changing the dressing, and follow-up visits. Take pain medication as needed. Avoid twisting, bending, and excessive lifting, as these may all interfere with the fusion process.
Recovery, including becoming pain-free, should take about 3 to 6 months and should be accompanied by a regimen of physical therapy. The worst pain typically subsides within the first month. Driving should be avoided initially and not resumed until you are not taking pain medication that may compromise your ability to drive safely.
As with any surgery, there are risks of complications related to infection or adverse reactions to anesthesia. Other known complications include failure of the fusion or breakage of the metal implant, blood clots, nerve injury, and graft rejection. Fusion of two vertebrae may add more stress to the adjacent areas of your spine. However, spinal fusion is a relatively low risk procedure with a low incidence of complications.