Rehabilitation after spinal surgery

One of the most common disorders in the functioning of the human body is problems with the spine. And unlike many diseases, they occur at any age, and not just because of maturity. Pathologies of the spine can be caused by injuries, concomitant diseases, and lifestyle habits.

One of the main methods for eliminating disorders in the functioning of the spine is surgical intervention. For a full recovery, a period of rehabilitation is necessary with strict adherence to the rules and recommendations of the doctor.

The main causes of dysfunction of the spine

Pathologies of the spine can occur for the following reasons:

• various diseases that are the result of degenerative-dystrophic disorders of the spinal column;
• car accident;
• strong blow/bruise of the back;
• falling from height.

In most cases, the cervical and lumbar regions are injured. With a lumbar injury, complete paralysis is not ruled out, with an injury to the cervical spine, the risk of death is high. In other cases, it is possible to restore the normal functioning of the spine through surgery. But they are appointed only in the case when the pathology cannot be eliminated by another method.

In what cases is surgery performed?

The patient is scheduled for surgery in the following cases:

• with severe deforming disorders of the spinal column, accompanied by severe discomfort, pressure on neighboring organs;
• in case of violation of the integrity of the spine after injuries;
• in the presence of tumor neoplasms;
• with scoliosis (in case of curvature at an angle of 40 ° or more);
• with pinched nerve endings (with a diagnosis of stenosis, intervertebral hernia);
• with congenital defects of the spine.

The above pathologies are accompanied by severe back pain, limitation or complete lack of mobility, flexibility. The progression of a violation in the work of the spine in the absence of timely medical care leads to disability.

Methods of surgical intervention

The method of operation is chosen depending on which part of the spine is deformed (lumbar, cervical, thoracic).

There are several surgical techniques:

1. Disc implantation. In this type of surgery, a damaged disc is replaced with an artificial implant. The most common surgical implementation for pathologies of the spine. However, in most cases, disc implantation is prescribed for patients over 50 years of age, if it is impossible to fuse the vertebrae in a natural way. See photo 1.
2. Vertebroplasty. During vertebroplasty, bone cementing material is introduced into the cavity of the damaged vertebra. The procedure is carried out with a special medical needle. After spinal surgery, the mobility of the spinal column is restored.
3. Laminectomy. It is prescribed for pinching the spinal cord. During a laminectomy, the defective vertebra (whole or a certain part of it) is removed.   
4. Discectomy. During a discectomy, the intervertebral disc and the herniated disc are removed. After this, the fusion of the extreme vertebrae occurs. Most often, discectomy is performed when the spine is damaged in the lumbar region.
5. Vaporization laser. The operation is performed by inserting a hollow medical needle with a laser beam. The laser removes the seal on the disc, thereby preventing its necrosis. See photo 2.
6. Endoscopy. One of the safest, minimally traumatic methods of spinal surgery. The surgeon performs all surgical manipulations with the help of small incisions. This makes it possible to exclude extensive damage to skin tissues, and the rehabilitation period is short (compared to other types of operations on the spinal column).
7. Nucleoplasty. A complex type of operation, since the structure of the intervertebral discs is destroyed. The destruction is carried out by an electrode, which is inserted into the damaged vertebral disc. After destruction, the disk is retracted.
8. Artodez. During arthodesis, damaged vertebrae are fused by transplantation of connecting parts. They are made from titanium, steel or donor bone material.

The most complicated operations in terms of technology are performed for pathologies of the cervical region. This is due to the inaccessibility of penetration to the damaged area.

Purpose of the rehabilitation period

Surgical intervention for spinal injuries is the main measure of therapy. However, a recovery period is required for full recovery. It is based on the careful preparation of the patient to return to normal life. Consists of the following steps:

1. Restoration of the motor, supporting functions of the body.
2. Preventive methods.
3. Compliance with the regime, training in the distribution of the correct load on the body.
4. Weaning from habits that arose during the period of illness.
5. The desire to restore normal indicators of all physical parameters of the body.

It is important to note that after spinal surgery, rehabilitation step by step is selected by the doctor individually for each patient. The type and complexity of the surgical intervention, the general physical data of the patient (gender, age, weight, the presence of concomitant and chronic diseases) are taken into account. The speed of recovery depends on whether the patient complies with all recommendations.

Rehabilitation after removal of the intervertebral hernia

Rehabilitation consists of several stages.

Early stage of patient recovery. The optimal period of the first stage of rehabilitation lasts about two weeks. The patient requires bed rest and absolute rest.

Supportive drug therapy is needed. Complex treatment consists of analgesics (Movalis, Ketotifen), anti-inflammatory drugs (Diclofenac, Ketorolac), chondoprotective drugs (Artra, Aflutop), antidepressants (Fluoxetine, Insidon).

Late stage of patient recovery. The second stage of rehabilitation lasts 2 months. Necessary activities:

• exercises from the complex of therapeutic physical culture, which contribute to toning, strengthening the muscular system;
• physiotherapy - massage, electrophoresis, ultrasonic / laser therapeutic effect;
• taking medications - at the discretion of the attending physician.

During the recovery period, physical activity and weight lifting of more than 3 kilograms are prohibited.

Preventive rehabilitation. At this stage, the patient must comply with a number of rules established by the attending physician. This applies to lifestyle, load distribution, adjustment of motor activity.

Failure to comply with the rehabilitation period can lead to a relapse of the disease.

Rehabilitation period after spinal surgery with the use of metal structures

The implanted part compensates for part of the spinal column and allows you to restore its functions. But a rather long and complex rehabilitation process is required, thanks to which it will be possible to facilitate the survival of a metal structure.

Stages of rehabilitation:

1. Strict bed rest. One of the most important periods of rehabilitation. Its duration is determined by the attending physician, depending on the general physical condition of the patient after the operation. The area of ​​the metal fixator in the spine is also taken into account (the larger it is, the longer the recovery time is required). Even minimal movements are not recommended, the patient must be immobile.
2. First movements. The patient begins to do the simplest movements after the operation only with the permission of the attending physician. Usually they relate to therapeutic exercises. The patient performs exercises lying in bed (for example, the treatment complex includes knee and elbow flexion, finger movements, breathing exercises). Gradually, the set of exercises expands, it is allowed to get out of bed for a short time. But it is strictly forbidden to be in a sitting position at an early stage of rehabilitation. In this position - a big load on the body.
3. Wearing a medical corset. An orthopedic corset provides additional support to the spine, and also protects against movements that can disturb the tranquility of the operated spinal region. The immobility achieved when wearing an orthopedic corset is necessary for faster and more correct fusion of the vertebrae. See photo 3.
4. Physiotherapy procedures. During the rehabilitation period, the patient after the operation needs not only exercise therapy, but also massage, physiotherapy. They are carried out under the supervision of a specialist.
5. Drug therapy during the rehabilitation period. Medications are prescribed to relieve postoperative symptoms and prevent the possible development of complications.

Optimal therapeutic course:

• painkillers - to relieve pain;
• anticoagulants - to normalize blood flow, protect against the development of pulmonary thromboembolism;
• anti-inflammatory drugs - to prevent the development of inflammatory processes;
• antibiotics - to protect a weakened body from all kinds of infections.

At the discretion of the attending physician, neurometabolic drugs are prescribed.

Special instructions in the rehabilitation of patients after spinal surgery with the use of metal structures

Any physical activity is strictly limited, as well as active movements (sharp swings of arms and legs, tilts). It is strictly forbidden to run, jump, go down the stairs on your own (only on the elevator).

If the above recommendations are not followed, there is a high risk that the implant will not take root, an inflammatory process will begin, and bone tissue pathologies will develop. As a result, a new period of rehabilitation or a second surgical intervention will be required.

On average, the rehabilitation course after surgery with the implantation of metal structures lasts up to 4 months. If the doctor's recommendations are not followed, it can drag on for a year or more.

Important! In case of intense pain in the back area, you should immediately contact a specialist!

Detailed description of treatment methods during the rehabilitation period after spinal surgery

At the discretion of the doctor, the patient needs a complex of medical procedures to recover from the operation.

Healing Fitness

Exercise therapy after spinal surgery is a mandatory technique during the recovery period. It is aimed at strengthening the muscles in the spinal column, restoring normal motor activity. The optimal course of classes is developed by a rehabilitation specialist. In an individual form, the types of exercises, the frequency of their implementation and intensity are determined.

Important! All movements should be performed slowly, smoothly, without sudden movements. It is unacceptable to overload the back. In case of discomfort, it is necessary to notify the attending physician. It may be necessary to change the teaching methods.

The initial stage of classes is exercises that carry a minimal burden on the patient's body. Gradually increase the intensity of repetitions. Standard exercise therapy technology - no more than three times a week. However, some exercises must be done daily.

Exercise therapy options for patients undergoing spinal surgery:

1. Lie on your back, arms out to the sides, palms up. With the fingertips of the right hand, slowly reach the palm of the left hand. After that, change hands. During the exercise, do not tear your hips and back from the bed.
2. Lie on your back, stretch your arms along the body. Clench your fists, at the same time slightly raise your head, and the feet of your feet towards you. After a few seconds, take the starting position.
3. Lie on your side, throw your left hand behind your head, right hand in front of you. Gently press your knees (on exhalation), return to the starting position (on inhalation).
4. Lie on your stomach, stretch your arms up. At the same time, raise your left arm, right leg, raise your head. Repeat the exercise, changing arms and legs.

At the initial stage of therapeutic training, do repetitions no more than two times. Gradually, the intensity of the exercises increases up to 15 times.

Kinesiotherapy

It is considered a difficult method of rehabilitation, since special gymnastic exercises are accompanied by pain. The developers of the technique believe that when overcoming pain, the patient is able to quickly defeat the disease itself. A set of exercises is developed for each patient individually.

With the help of kinesiotherapy, the musculoskeletal system is strengthened and the endurance of loads on the back is increased.

Massage

For each patient (depending on the type of spinal surgery performed), an individual form of massage is selected - hardware, classical, acupressure, segmental.

Massage helps to strengthen the muscles of the back, improves blood flow, normalizes metabolic processes in the body, relaxes, reduces or completely eliminates pain. Massage is included in the mandatory complex of medical procedures for patients who have undergone spinal surgery.

Physiotherapy

Physiotherapy is carried out by the method of exposure to the operated area with ultrasound, current, heat or cold. With the help of such technologies, it is possible to reduce or completely eliminate pain, improve blood circulation and tissue regeneration.

Reflexology

Reflexology is recognized as one of the most modern and effective therapeutic methods by influencing certain points of the body. It is carried out with the help of acupuncture or a specific form of massage (stone therapy or vacuum massage). There is an activation of the body's own internal forces, allowing the patient to take fewer drugs.

Orthopedic corsets, bandages

The patient is prescribed to wear a corset or bandage for the first time months after spinal surgery. They allow the bones to grow together properly, reduce pain symptoms, and normalize blood flow.

Bandages and corsets come in different shapes, sizes and stiffness. They are selected by a specialist depending on which area of ​​the spinal column the operation was performed on (lumbar, thoracic, cervical).

Important! In the event that the corset / bandage is chosen incorrectly, incorrect fusion of the vertebrae may occur. Also, the patient may experience severe discomfort.

Performing exercises on a verticalizer

The verticalizer is a special therapeutic simulator that allows you to eliminate the negative consequences of prolonged lying in a prone position (the patient may experience muscle dysfunction, bedsores, pain syndrome). With the help of a verticalizer, the patient after surgery can take a vertical position. Systematic exercises on the simulator contribute to the activation of the pulmonary, cardiovascular systems, the normalization of the body's metabolism.

The general rehabilitation period lasts on average from 3 to 12 months. However, after its completion, a person who has undergone spinal surgery is obliged to follow a number of rules for life. These primarily include restrictions on physical activity, adherence to a healthy lifestyle, regular exercise therapy. It should not be excluded and annual examinations by a specialist.

Rehabilitation after spinal surgery is required for the full recovery of the body. Surgery is not an absolute positive factor that the patient will return to normal life. The rehabilitation period allows the spinal column to optimize its work. According to statistics, strict adherence to the recommendations of the doctor allows patients to return to the optimal level of capacity.