What to expect if I have Cervical Surgery
Most cervical surgeries that are done through the front or anterior have a very short hospital stay. The patient is generally home the next day. The braces are optional. Most patients who have anterior cervical surgery have problems swallowing for a day or two. Sometimes their voice is harsh or hoarse which can be from vocal cord dysfunction. Generally this is temporary and in some patients it is permanent. Most patients with anterior cervical surgery suffer muscle spasms in the back of their neck and along their shoulders. This generally starts getting better in about three to four weeks and most patients with cervical surgery start active rehabilitation in physical therapy in two weeks.
Some patients with very large anterior cervical fusions need a posterior fusion, which requires moving muscles in the neck. This is a much more painful operation than the anterior cervical and generally requires a day or two stay in the hospital and is a slower rehab. Therefore, my preference is to treat patients with anterior cervical surgery and reserve the posterior for very long fusions in the neck or for patients with very soft or brittle bone that are at risk for the screws and plates to pull out.
What to expect if I have Lumbar Surgery
If you have a simple microdiscectomy, generally that is an outpatient procedure and you can go home in an hour or two. Once your sutures are out at two weeks your activity can be almost normalized. You will be in rehab in two to three weeks.
If you have a minimally invasive posterior laminectomy or removal of spurs, this also can be done as an outpatient or an overnight stay. A brace is not necessary. Your rehabilitation will be fairly quick.
If a lumbar fusion is needed, using a Co-Flex F at a single or double level, along with the decompression or removing the pressure from the nerves, generally this is a one to two day hospital stay, the blood loss is minimal, and you will have a drain which is removed in two or three days, and once your sutures are removed you will start rehab at two to three weeks. Generally a brace is not needed.
If a rod/screw construct is needed in a more traditional way, this is a longer hospitalization and is significantly more pain, and higher blood loss, as well as a longer rehab. There are conditions where that is mandatory, such as isthmic lytic spondylolisthesis or a failed minimally invasive surgery.
What if I have Anterolateral Surgery through the side of my Lumbar Spine
This is also quite minimally invasive. The anterolateral has much less blood loss, much less postoperative rehabilitation, and much lower extremities hospital time. Generally, if multiple levels are done, this is done at the same setting. There are times that you need to do both left and right and generally are done at the same setting or may be two different settings.
Direct anterior surgery, if you have that, you will be in the hospital probably two or three days. This is a much more painful extensive operation than the lateral. This is done by a team of surgeons and the recovery time is about six weeks. Generally you are in the physical therapy at two to three weeks. The overall recovery time is about three months.
What can I expect if I have anterior or “through the front” and “through the back” surgery?
In the elderly population these are done at two different settings or two different anesthetics one to two weeks apart. In the younger age group the simultaneous or at the same time the anterior surgery and the posterior surgery are done. This is generally two to three days of hospitalization and rehabilitation and physical therapy begins at two to three weeks and this takes about 12 weeks to achieve a significant functioning level.