4 Prep Tips for Successful Back Surgery

There are smart steps you can take before you head to the operating room to increase your odds of getting relief from your spine surgery.

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If you're someone who is dealing with a painful back condition such as spinal stenosis, spondylolysis, spondylolisthesis, or degenerative scoliosis, you know that low back surgery could await you in the near future. Or perhaps you’ve already scheduled your surgery and you’re wondering how you can be an active participant in your health and help ensure your surgery is successful.

Family support for spine surgery recoveryGetting your support system in place is crucial for a successful spine surgery recovery.

To achieve success from your back surgery, you have to start with the basics, and that’s your doctor’s orders. 

Theodore Choma, MD, University of Missouri Health Care Spine Surgery Division Director, explains that when a patient decides to proceed with surgery, he first talks through the major risks with them and the expected restrictions, wound care, and number of days in the hospital. 

His team also schedules patients for a one- to two-hour “Spine Camp” run by nurses and therapists. “This explains to the patients in greater detail what their inpatient stay should be like, the fact that we will begin mobilizing them out of beds on day of surgery, and more,” Dr. Choma says. “It also allows the patients more time to ask for clarification, as well as begin to get to know the people who will be taking care of them throughout the process.” 

Although this is an excellent way to go about preparing for back surgery, there are some further steps you can take to bring about positive results. 

Study: Motor Weakness Can Affect Surgery Outcome

In 2021, Spine published a Japanese study that detailed that participants with weak leg muscles due to stenosis were more likely to continue having trouble walking and ascending stairs after surgery.

“Motor weakness can occur when one or more of the nerves become crowded in lumbar spinal stenosis, which is a narrowing of the nerve passageways,” Dr. Choma says. As the study pointed out, this can result in degraded leg muscles. 

“In a common scenario, the patient has difficulty lifting the foot, and toes can get caught on flooring as a patient attempts to step through while walking,” Dr. Choma has observed. “This causes the patient to have to concentrate harder to walk, and often, lift the entire leg higher for each step, resulting in a ‘slapping gait.’ These patients are also at a much higher risk of falling.” 

Get Stronger and Improve Motor Weakness

While a loss of muscle strength goes hand-in-hand with many back conditions, it can be improved, something that can help you if you’re preparing for spinal fusion surgery. Getting stronger before surgery can encourage a better result afterwards. 

“Engaging in almost any exercise program before surgery is better than not exercising at all,” Dr. Choma notes. “Often, patients with spinal stenosis will have limitations in walking before surgery, so exercises like the stationary bike are better tolerated. Lifting light dumbbells and water aerobics can be helpful as well.” 

2. Quit Smoking ASAP

Smoking places a dire amount of stress on the back, and it’s essential to quit to have a good outcome from surgery. 

Dr. Choma says, “Smoking puts a patient at greater risk of having wound problems, such as wound infection.” 

He adds that in surgeries that involve spinal fusion, smoking doubles the risk that the fusion won’t heal. 

“As such, smoking cessation is imperative before surgery,” Dr. Choma asserts. “Although this has not yet been well-studied, optimally, one would become completely nicotine-free at least two months before spine surgery.”  

3. Manage Post-Surgery Expectations

You may go into surgery with expectations of how it will turn out. Maybe you’re envisioning a lot of pain, or perhaps you’re hopeful that you’ll experience little to even no pain. According to Dr. Choma, those expectations can land somewhere in the middle, something that can help you be realistic about the outcome.  

He says, “Your doctor and team will likely employ multiple modalities to manage your pain after surgery—these can include medications, guided activity, and mindfulness—but some pain while healing should be expected.” 

4. Line Up Caretakers 

Since Dr. Choma points out that the majority of lumbar spine surgeries involve an incision on the back, this means that it’s necessary to arrange for someone at home to perform dressing changes and wound cleaning for a few days after being discharged. Since this can be a “logistical challenge” for people who live alone, as he says, it’s key to line up help before the surgery. 

Dr. Choma believes that the course is smoothest after back surgery when a patient has assembled a care team well in advance. 

“Most patients will need to identify someone who can help them with dressing changes for a few days after discharge from the hospital,” Dr. Choma says. “In addition, although they will likely be able to walk around under their own power by discharge, they will probably need someone to fix meals, run groceries, and possibly perform a few household chores for a few weeks after discharge home. It’s better to have arranged that prior to surgery.” 

Don’t think that spine surgery success is solely determined by—and is the sole responsibility of—your surgeon. By following these tips before surgery, you increase your odds of getting relief from your back condition. It’s important to take an active role in your healthcare, and there’s no better time to start than today. 

Updated on: 03/16/21
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Do’s and Don’ts for a Successful Back Surgery Recovery
Theodore Choma, MD
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