It is normal to have pain after the operation, especially in the lower back. This does not mean that the procedure was unsuccessful or that your recovery will be slow. Leg aching is also not unusual, caused by inflammation of the previously compressed nerve. It will go away slowly as the nerve heals. You may experience muscle spasms across your back and even down your legs. Medication will be given to control pain and relieve spasm. Moist heat and frequent repositioning may also help.
You may move about in bed and rest in any comfortable position when you have recovered from anesthesia. Walking may begin within several hours. The easiest way for you to get out of bed is to raise the head of the bed as far as it will go, and then swing your legs to the floor. Use the trapeze to change positions in bed. During the first few trips from bed, you will require help from a nurse to avoid falls or injury.
Usually, you may take a shower the day after surgery. This will make you feel better and should be done with the dressing left in place to protect the incision. Your nurse will change the dressing afterwards. Lotion may then be massaged into the lower back, including the area around the incision to eliminate dryness and help relieve muscle spasm.
Intravenous (I.V.) fluids will be discontinued when you can tolerate regular liquids without nausea or vomiting. Your diet will then be adjusted back to normal as your appetite returns. Constipation will be treated with laxatives and a diet of whole grain cereals, fruits, and fruit juices.
It is normal to fee discouraged and tired for several days after surgery. These feelings may be your body’s natural reaction to the cutback of extra hormones it put out to handle the stress of surgery. Although emotional let-down is not uncommon, it must not be allowed to get in the way of the positive attitude essential to your recovery and return to normal activity.
Discharge from the Hospital
The hospital stay for lumbar laminectomy patients usually lasts from 3 to 5 days. This will be determined by your progress and by the amount of comfort and help available to you at home.
Daily walking is the best exercise. Try to increase your distance a little each day, setting a pace that avoids fatigue or severe pain. You may climb stairs when you feel able. Avoid sitting or standing for long periods of time. Change positions frequently to help eliminate lower back muscle spasms and leg aching.
Sexual relations may be resumed during the recovery period, but positions that strain the back or cause pain should be avoided.
“Listen” to your body. Discomfort is normal while you gradually return to normal activity, but pain is a signal to stop what you are doing and proceed more slowly.
During the recovery period, it will help to take several short rests throughout the day. If lying flat, place a small pillow or rolled towel under the small of your back. The best positions for resting are on one side with the top leg bent up, or on your stomach. Waking up with a stiff back is not uncommon and may be relieved by taking a short walk or a warm shower. A firm mattress is important for proper back support.
Your doctor will help determine when you can return to work and with what limitations. If your job requires lifting, twisting, or bending, a work release may be given to you during the first postoperative visit.
Driving Drive a car only when you have recovered full coordination and are experiencing minimal pain. Do not drive after taking pain medication.
You should gradually use less pain medication while recovering at home. This can be accomplished by increasing the amount of time between taking pills, then by reducing the number taken each time. A certain amount of discomfort and pain in the lower back can be expected until the inflammation and nerve sensitivity have subsided. Heat, exercise, massage, and short rest periods will also help relieve pain.
It is important that you develop a general physical fitness program. Being overweight or out of shape strains the lower back and will delay recovery. Controlling weight will help you develop a stronger and more flexible back. Exercises must also be done every day to build up strength and keep muscle tone.
If the skin sutures were removed before your discharge from the hospital, it is not necessary to keep the incision covered. Unless instructed otherwise, you may take a daily shower or tub bath, which will help you feel better. Let the water run over the incision, but do not scrub or rub over it. Pat it dry. After bathing, massage lotion over the tightened muscles of the lower back and buttocks.
If you notice increased redness, swelling, or any drainage around the incision after leaving the hospital, notify your doctor.
A well balanced diet is necessary for proper healing. Include foods from each basic food group: dairy products, meats, vegetables, and fruits. Since you will be less active during recuperation, avoid rich, heavy foods and those high in calories but low in nutrients.
Healing and Recovery
Healing Healing is the body’s natural process of restoring its damaged tissues to a normal or nearly normal state. Although healing may be improved by general good health, proper nutrition, rest, and physical fitness, it will occur without your having to work at it.
Recovery is the process during which you work to become well. It requires a gradual but persistent effort to increase physical strengths and minimize weaknesses. You must concentrate on what is improving, rather than on what symptoms remain. This focus on progress that has been made, combined with the constant effort to improve, make up the positive attitude that will speed your return to normal daily activity.
Making Sure You Understand
Test your knowledge of lumbar laminectomy by answering the following questions.
- What is the function of the intervertebral discs in the spine?
- What is meant by “nerve root compression”? What symptoms can it cause?
- What is a herniated disc? A bone spur? A disc fragment?
- What happens to the empty space left between the vertebrae after the disc material is removed?
- Why, after surgery, is there still pain in the back – sometimes even temporarily worse than before surgery?
- What will help relieve back pain besides medication?
- After the operation, should you stop any activity that causes discomfort?
- What is the difference between healing and recovery? How does a positive attitude affect each?
- Are you comfortable with your understanding of the risks of this procedure? Do you realize the part human effort plays in its expected outcome?
The human body is an intricate network of interrelated systems. Each system functions on its own but is also influenced by and dependent upon the others. When illness or injury occurs, it disrupts the function of one or more of these systems.
Surgery is a human effort made to correct one system’s malfunction, but it will affect all others. Because of this complex interrelationship, surgical outcomes cannot be predicted.
When recovery is possible, it occurs as a combination of the surgeon’s effort, the patient’s faith, and a positive acceptance of the outcome.