If a patient experiences back pain with signs of a neurological disturbance in the extremities or thoracic region they should have an MRI of the affected area. Only if their symptoms correlate with severe pathology seen on the imaging study, should a doctor recommend spine surgery. A neurosurgeon or orthopedic spine surgeon should make the final decision about whether surgery would benefit the patient’s condition and whether or not a spinal fusion surgery is necessary. The CNSO neurosurgeons and orthopedic spine surgeons only offer a spinal fusion when it is indicated. A spinal fusion may be required if there is damage to one or more spinal bones or intervertebral discs because it can cause the spinal column to destabilized and lead to spinal cord impingement. During a spinal fusion, the fractures or problematic vertebral bone(s) are minimized or if necessary, completely removed. Given the need to trim or remove bone, the spinal column alignment and height will need to be maintained, corrected, or restored, depending on the patient’s pathology. The use of a prosthetic device helps secure the spinal column in place. Placement is maintained by the use of the appropriate size titanium screws and perhaps a plate or rod if the pathology is severe.
Spinal fusion surgery has been proven to eliminate or significantly reduce back pain and any other related symptoms. The recovery time can take a few weeks, up to three months. The range of recovery time depends on the age, extent of the surgery, and overall health condition of the patient. The younger and healthier the patient, the quicker the recovery. Learn more about the indications for spine surgery, whether a spinal fusion is necessary, and the recovery process for any type of back pain from insights of the neurosurgeons and orthopedic spine surgeons at Centers for Neurosurgery, Spine & Orthopedics.
Pain Control after Spinal Fusion
During the post-operative period pain levels may vary, depending on the level of the spine corrected, the individual’s pain tolerance, and the number of levels of the spinal fusion. Many people who undergo a cervical spinal fusion, for example, report very little pain afterward. In fact, their pre-operative pain often resolves immediately after the surgery. After a lumbar spinal fusion, patients typically are more likely to experience tolerable discomfort.
If the patient has a complex spine deformity or a significant portion of the spine is pathologically curved, such as when multiple vertebrae levels are affected by scoliosis, then a more extensive spinal fusion needs to be performed. In this case, there may likely be a greater need for pain medication immediately following surgery. Typically, as a CNSO patient immediately begins to recover, their pain is controlled and rapidly resolves. Within one month they are very happy they made the choice to have their spinal fusion.
The surgeon can provide multiple strategies for managing post-surgical pain and often engage a pain management specialist to manage the care. These approaches may include:
- Intravenous pain medication while in the recovery room
- Oral non-opioid pain medications to take as prescribed at home
- Oral opioid pain medications while hospitalized and at home
- Muscle relaxant medication
Most spine surgeries require less pain medication than expected. Although opioid pain medication (a.k.a. narcotic medication) may be necessary to properly manage post-operative pain, it will be prescribed only as needed. The CNSO team will monitor patients so they have the least amount of opioids necessary for the shortest possible period of time. Most CNSO patients are off all narcotics within three months after a spinal fusion.
Depending on the extent of the surgery, the incision may vary in size. CNSO surgeons often have only a one to two centimeter size incision. The size of the incision will determine the amount of pain and the extent of a scar. Different than other surgeons, at CNSO, the neurosurgeons and orthopedic spine surgeons make every effort to minimize the size of the incision. They utilize minimally invasive techniques, intraoperative imaging, and robotics to achieve the optimal surgical outcome with minimal scarring. If the appearance of a scar is a concern, be sure to discuss it with the surgeon in advance of the surgery.
Typically, a surgeon will provide specific instructions about how to care for an incision. Part of this care plan is based on the location and extent of the incision. Incision care directions will most likely include:
- A few days after the surgery, the incision can be gently cleaned as directed with mild soap and running water. Pat with a towel to dry.
- Avoid soaking in water, such as a bathtub, hot tub, or swimming pool for a specific period of time.
- Watch for signs of infection, such as a fever, spreading redness, and warmth at the incision site.
Wearing a Brace May Be Necessary
Whether a spinal fusion surgery occurred in the neck or the lower back, the patient may be fitted with a customized brace. The brace provides additional safety and security for the new spinal fusion construct because it will slightly restrict movement at the freshly treated spine segment level. This restriction allows for the growth of new bone which will further encourage the fusion process to occur more rapidly as well as prevent the newly placed hardware from dislodging until the fusion process is complete. For a short period of time, these braces may need to be worn 24 hours a day. The brace can be removed for showering. If the patient were to stop wearing the brace prematurely, it will prolong the healing period and could cause serious post-surgical complications. The neurosurgeon or orthopedic spine surgeon will review the bracing instructions, along with any other personalized aspects of a patient’s post-surgical care plan.
Post-operative instructions will describe the types of activities that can be encouraged as well as those that should be avoided and for what period of time. The goal should always be to return the patient back to their daily lifestyle as soon as possible. But during the immediate healing phase, the activity recommendations will differ, depending on the fusion level of the spine surgery. General guidelines to follow immediately after a spinal fusion surgery are:
- Stay active throughout the day walking and performing your usual daily tasks
- Avoid bending or twisting motions at the affected spine segment.
- Avoid lifting or carrying objects heavier than 5 lbs.
- Wear the brace as instructed.
- Do not participate in strenuous activities of any kind (i.e. running, golfing, tennis, home improvement tasks, etc.).
Learn More about Spinal Fusion Recovery
Hospitals in Northern New Jersey have the most advanced technology, and treatment at CNSO is very personalized and top tier. Spine fusion should be avoided unless it is necessary. The CNSO neurosurgeons and orthopedic spine surgeons will determine the correct diagnosis and the appropriate spine surgery based on the patient’s goals. Learn about treatment options for neck and back pain along with how the Centers for Neurosurgery, Spine & Orthopedics team provides a rapid recovery. CNSO treats patients for a variety of different back and spine conditions and injuries. For the best care, contact CNSO for a consultation at one of the six convenient office locations in Northern New Jersey.