Recovering from spinal cord surgery

Spinal cord injuries are the result of both accidents and lifestyle habits. We can avoid developing a weak spine by adjusting our lifestyles. Unfortunately, the same cannot be said for accidents. A car accident or slipping over can lead to tremendous long-term discomfort and pain with little we can do to prevent these damages, assuming you're wearing your seatbelt and not running on unstable surfaces. Nonetheless, there are ways we can tackle this issue using advances in medical science. Spine surgery can have incredible effects on your quality of life. Let’s investigate how you can plan your recovery after a surgery. Please note that timestamps are generalized and dependent on your health and recovery plan.

Spine surgery is one of the more common types of surgery, and most are minimally invasive.  Let’s take a look at what spine surgery can do for you.

Firstly, when you’re in the hospital, you may have one of these surgeries depending on what type of damage you have incurred.  

·       Diskectomy – surgery to remove all or part of your disk

·       Foraminotory – surgery to widen the opening in your back where nerve roots leave your spinal column

·       Laminectomy – surgery to remove the lamina, two small bones that make up a vertebra, or bone spurs in your back, to take pressure off your spinal nerves or spinal column

·       Spinal fusion – the fusing of two bones together in your back to correct problems in your spine

Your physician will give you a bespoke plan relating to your damage and recovery plan.

Depending on your surgery, recovery could take anywhere between 3 weeks to 6 months to recover. Other conditions that could affect your recovery is your lifestyle and bodily condition before the surgery.

Your bandages have a lifespan of approximately 9 days.  Check to see if the area has changed colour, swollen, or begins to open up. If this happens, contact your surgeon immediately. If there are no issues, you may begin to shower again. Wait 5 days before showering, and cover the incision with plastic wrap. Do not allow shower from the head to spray the wounded area. You should also want to avoid stairs for the first week or so.

Once a few weeks have passed, and the healing process is underway, you should be attempting to work your way into your previous routine. Before continuing your rehab, please note: do not sit still for extended periods of time, and inform yourself on proper posture by reading this. If you are supported by a brace or corset, you should be wearing it when sitting and walking, however, it would be unnecessary to wear the brace when you are sitting for short periods of time or using the bathroom at night. Finally, do not drive for the first 2 weeks.

Now is the point where, as opposed to what you should avoid, we can start looking at how you can actively help the healing process.

Around the 4 week stage, generally, you should be taking light walks to strengthen surrounding areas. Increase the speed or duration of the walk slowly. This allows the spine to heal itself within an active body and correct itself. A sedentary lifestyle will encourage previous problems to return. Continue to up your exercise slowly as your spine recovers.

Please note, you should contact your surgeon immediately if you experience any of the following:

·        Chills or a fever of 101°F (38.3°C), or higher

·        More pain where you had your surgery

·        Drainage from the wound or the drainage is green or yellow

·        Lose feeling or have a change of feeling in your arms (if you had neck surgery) or your legs and feet (if you had lower back surgery)

·        Chest pain, shortness of breath

·        Swelling

·        Calf pain

·        Your back pain worsens and does not get better with rest and/or pain medicine

·        Difficulty urinating and controlling your bowel movements

If this routine does not help, or you need medical attention, please contact us at Mount Sinai Department of Rehabilitative Medicine. A bespoke plan will be necessary if you suffer from other medical problems. Contact our switchboard on: (212) 241-6321

Laminectomy, The Surgical Response to Sciatica

Laminectomy, the surgical response to sciatica

Sciatica is a symptom of spine damage that can usually be remedied at home. There are a myriad of steps you can take in tending to sciatica without needing surgery. However, in some cases patients need to undergo surgery to alleviate their symptoms. This procedure removes the lamina (a small vertebra in the spine), it may also remove bone spurs in your spine and takes anywhere between 1 and 3 hours. This process has the aim of reducing pressure in your spinal column; in turn lessening the symptoms of sciatica. 

The procedure is often done to treat spinal stenosis. It removes damaged bones or discs. As we explored in last week’s blog, sciatica is a symptom, and not a cause – and the best way to cure sciatica is to tackle the underlying problem. 

It is important to have an x-ray or MRI of your spine before making any decisions to undergo surgery. You must divulge any medication you are taking to your health provider.

Before you leave your home, ensure you leave it prepared for when you return. You must refrain from smoking in the days leading up to your surgery. It is imperative you do not smoke after the surgery is complete. You must speak with your doctor if you have been drinking lots of alcohol, especially if your consumption could be considered alcohol abuse. 

You will likely be asked to not drink or eat anything for 6 – 12 hours before the procedure. With everything prepared, you are ready undergo your Laminectomy. 

Laminectomy opens your spinal column with the aim of giving spinal nerves more space to move. You will be asleep and feel no pain. The procedure begins with you lying face down on the operating table. Once the anaesthetic kicks in, the surgeon makes an incision in your back.

The skin, muscles, and ligaments are moved to the side. Depending on the cause of sciatica, part or all of the lamina bones may be removed on both sides of your spine. Your surgeon may then remove small disc fragments, bone spurs, or other soft tissues. The muscles and other tissues are back in place. The skin is sewn together.

After waking, you will be encouraged to get up and walk around as soon as the anaesthesia wears off. You will be allowed to go home around 1 to 3 days after their surgery.

You will be able to drive within a week and resume light work after around 4 weeks. The surgery should relieve the patient of all symptoms of sciatica due to addressing the root cause of the problem.

As we have stressed in previous blogs, surgical procedure is not recommended as a treatment for sciatica – it should be a last resort and not a go-to when the symptoms of sciatica kick in. Before thinking about surgery, you should consult your physician and discuss options. Alternatively, you can read our blogs on living with sciatica found here.

Sciatica usually goes away on its own if you follow our guidelines. However, if you need a consultation, or are suffering from any of the symptoms outlined at the end of the article, please contact us on (212) 241-6321 to book an appointment.

How to Deal With Sciatica, The Do’s and Don’ts

How to deal with sciatica, the do’s and don’ts

This week, we are going to look at ways of managing sciatica. In our previous blog we looked at what sciatica is, and suggested some causes of the problem. To quickly recap, sciatica is the compression of the sciatic nerve – which in turn causes pain down the lower back, through the hamstring all the way to the foot. What is most important to remember when dealing with sciatica, is that is a symptom, and not the underlying problem itself.

The first step when dealing with sciatica is diagnosing the underlying issue. The root of the problem can be anything from a slipped disc in the spine, to a spinal stenosis, or in more serious cases, a tumor. It could even come from a small fracture in the hip. Although we can treat sciatica without dealing with the genesis of the problem, you are more likely to experience a reoccurrence of sciatic pain if we do not.

We recommend that if you suffer from sciatica, get a diagnosis on what caused it. That way we can deal with the pain alongside remedying the original problem, and reduces the chances of it reoccurring.

For now, let’s look at some of Mount Sinai’s recommendations for dealing with sciatica at home.

Conservative (non-surgical) treatment is best in most cases. When you are suffering from sciatica, or begin suffering due to some other cause, apply heat or ice to the painful area. Try the ice first (48-72hrs); then use heat on the pain. Over the counter pain relievers such as ibuprofen or acetaminophen can also help with inflammation and general pain relief.

Surprisingly to a lot of patients, bed rest is not recommended. Although short term bed rest may be needed for patients in extreme pain, staying inactive and reclined for long periods of time weakens the body and extend the life of agonizing symptoms.

Upon first suffering the symptoms of sciatica, it is recommended to tone down your physical activity for the first few days, and gradually work your way back to your daily routine.

You should reduce your activity in the first couple of days – and gradually adjust your body to your usual activities. This will ensure you do not overstress any of the damaged components, and give your body time to adapt.

Patients are recommended to start exercising again after around 2-3 weeks. You should include exercises to strengthen your abdominal muscles and improve flexibility in your spine.

If weightlifting or contact (collision) sports such as American Football are part of your usual exercise routine, you should not return to your sport/hobby for at least 6 weeks since the pain began. Do not lift heavy objects or twist your back. Your physician can help identify good exercises to remedy sciatica.

More serious complications depend on the causes of sciatica, such as slipped discs or spinal stenosis. Call a provider immediately if you have:

·        Unexplained fever with back pain

·        Back pain after a severe blow or fall

·        Redness or swelling on the back or spine

·        Pain traveling down your legs below the knee

·        Weakness or numbness in your buttocks, thigh, leg, or pelvis

·        Burning with urination or blood in your urine

·        Pain that is worse when you lie down, or awakens you at night

·        Severe pain and you cannot get comfortable

·        Loss of control of urine or stool (incontinence)

Also call if:

·        You have been losing weight unintentionally (not on purpose)

·        You use steroids or intravenous drugs

·        You have had back pain before, but this episode is different and feels worse

·        This episode of back pain has lasted longer than 4 weeks

Sciatica usually goes away on its own if you follow our guidelines. However, if you need a consultation, or are suffering from any of the symptoms outlined at the end of the article, please contact us on (212) 241-6321 to book an appointment.

Supporting a Loved One through Rehabilitation

Supporting a loved one through Rehabilitation can be one of the most difficult and isolating experiences there is. Serious injuries, and the subsequent care, can affect families and caregivers as much as the individual themselves. However, there are steps any caregiver can take to do make the transition to rehabilitation as smooth as possible.

The first thing to remember to do always is take care of yourself. If, at any point, you find yourself feeling too isolated or too stressed, reach out to other people – be they friends and family, an external support group, or a doctor. Learn to relax, get enough sleep, and find out which coping strategies work best for you – and this applies to all caregivers.

Brain Injuries

Daily structure and normality are extremely helpful for those coping with a brain injury. Be sure to stick to a routine every day, factoring in plenty of rest and limiting the number of visitors and amount of noise, so as to avoid over-stimulation. Include your loved one in family activities and conversations, wherever possible, and do whatever you can to be as natural as possible with them. Remember to be respectful, treating them as an adult and being sure to consider their likes and dislikes. Point out milestones and try not to lose patience. You should also bear general safety matters in mind – make sure there is no clutter around for the sufferer to trip on, and keep sharp objects out of harm’s way.

Stroke

The road to recovery after a stroke is different for every patient, as there are a number of complex variables which can lead to someone having a stroke. The most important thing to remember, then, is that comparisons with other people’s rehabilitation can only be harmful, not helpful. Steps forward can come quickly or slowly, so have patience, measure progress, and stay positive. Depression is extremely common after a stroke, so monitor your loved one’s mood and behavior, and step in if you notice any signs of depression. Also, it is important that you are clued-up on medication and instructions given by the physician, especially those which relate to preventing future strokes. Encourage a healthy diet and exercise, and make sure all medication is being taken as prescribed.

Sports Injuries

Sports injuries vary enormously – from acute injuries incurred during a game to wear-and-tear injuries from repeated use. They can also affect vastly different parts of the body and take different lengths of time to heal, but there are some general rules which should help with all of them. Firstly, be sure that the injured person sees the doctor regularly throughout their rehabilitation, and that they take their advice and instructions seriously. Motivate them through difficult aspects such as physical therapy while being sure not to encourage them to get back into their sport of choice before they are ready.

Wheelchair

It is important to bear in mind that, life in a wheelchair can be extremely challenging – particularly for those who are new to it. To begin with, the crucial thing is simply to be there for your loved one, and to remind them of this sensitively, without constantly reminding them of the things they can no longer do. One of the trickiest things, our patients’ families find, is learning to tread the fine line between drawing constant attention to the wheelchair and conspicuously not mentioning it. This may take time and effort, but you will get there. Adapt your home to make it as wheelchair friendly as possible – this is something your hospital or medical center can help you with. Finally, be prepared to help them in any way they need – especially at the beginning. There may be a number of everyday activities they find difficult to do on their own – from bathing to dressing – and it is imperative that you lay any reluctance to one side and do what is necessary. Over time, they may well learn to do these things without you.

Spinal Injuries

Experiencing a Spinal Cord Injury can profoundly change the way in which someone interacts with the world. As a caregiver, it is crucial that you make this transition as painless as possible. Sufferers often experience high levels of guilt, frustration, and depression – as well as physical pain – so it is your role to help prevent this, whenever possible, and never to let your loved one feel like a burden. Be prepared to face these emotions, and try to communicate openly and often with your loved one about them. On the whole, it is good to interact with them as you normally would. One of the best things to do is to work out early on which tasks the patient can complete independently and which tasks could use your assistance. Keep the whole family or household involved and be sure to nurture healthy, positive relationships – providing your loved one with as much contact with the outside world as possible.

When it comes to rehabilitation for any serious condition, your role is vital. Your love, care, and support can be the difference between a patient recovering, and them not recovering. It is a role which is exceedingly challenging, but which can be hugely rewarding and, whatever the condition of your loved one, it is always important to remember: you are doing a good job.

Top Tips for a Healthy Spine

Back pain and spinal conditions can be some of the most debilitating that there are. According to NINDS (the National Institute of Neurological Disorders and Stroke) lower-back pain is the leading cause of job-related disability, and – worst of all – back pain can be particularly difficult to diagnose and treatment can take time. All this considered, it is worth doing everything you can to ensure that you keep your spine healthy – either to manage existing back pain or to prevent its occurrence altogether. To help, this week our Mount Sinai spine care experts have compiled a list of useful tips for keeping your spine healthy.

1. Stretch and Strengthen

The spine is supported by a complex system of muscles. 20-30 minutes a day spent toning and strengthening the abdominals and the muscles in your lower back can help keep them strong and flexible, taking pressure off the spine. Stretching frequently is invaluable too. A short routine of targeted stretches first thing in the morning can help keep you supple, maintaining joint function and range of motion and reducing your risk of back injury.

2. Sleep smart

Sleep is essential for helping the body heal and repair itself after a long day, so it is important that you are maximising its effectiveness when it comes to spinal health. Research pillows and mattresses before you buy them to ensure you are getting the correct level of comfort and support for your back. If you find yourself feeling stiff or in pain in the mornings, it could also be a sign that your sleeping position is putting unnecessary pressure on your spine, so perhaps try sleeping on your side.

3. Practice healthy working habits

That spending hour upon hour sitting at a desk is bad for your body is a well-researched fact. Not only can sitting for long stretches of time exacerbate a back condition – it can even create one, as the discs in the lower spine are loaded three times more while sitting than while standing. From unsupportive chairs to desks at the wrong level, office life and a healthy spine can often seem incompatible, but there are some key things you can do to minimise this. Be sure to get up and stretch every half hour, walk around whenever you can, and do what you can to find an office chair which offers support and a desk set to the right height for you.

4. Exercise

Getting and staying active is a healthy choice for more than just your spine – but it can be particularly helpful. Increasing your heart rate will encourage blood flow, bringing nutrients to the spine to fuel it and help it heal. An exercise routine which involves aerobic activity, stretching and strengthening, as we mentioned above, is particularly good. Being unfit increases your risk of lower back pain considerably, as does being overweight, or gaining a considerable amount of weight in a short period of time. Excess weight puts extra stress on ligaments, tendons and muscles in the lower back – another excellent reason to hit the gym.

5. Listen to your body

And, finally, we would urge you to remember that pain is never normal, nor is it something you should accept. Pain, or even discomfort, in your back could be an indicator of more serious issues, so do not ignore it. Get regular check-ups and make an appointment with your doctor if you notice any pain – be that after lifting something too heavy, persistent stiffness from sitting still, or an unexplained twinge for no obvious reason. 

If you are experiencing back pain of any kind, please reach out to us by telephone on 212-241-6335 to make an appointment.