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What Can I Expect While in the Hospital?

From the moment your have spine surgery is completed, the nursing staff will begin monitoring your condition. When the anesthesia begins to wear off, you will be taken to a hospital room until you are ready to go home. When you wake up from surgery, you may feel groggy, thirsty, or cold. Your throat may be sore. For a few days, you may also have:

• Tubes to drain the incision
• An IV to give you fluids and medication
• A catheter (tube) to drain your bladder
• Boots or special stockings on your legs to help prevent blood clots

Day 1

The day after surgery is considered "Day 1." Some spine surgeries require that you wear a brace for a period of time afterward. If so, keep your brace on until your surgeon specifically instructs you to remove it. You may be encouraged to stand and sit (with assistance if needed) within the first 24 hours after surgery. If so, with the supervision of a physical therapist (PT), you will sit on the edge of the bed and stand with support. Walking, however, will be approached gradually and carefully to avoid injury and complications. Try not to over do it the first few times you get up and walk.

• Treatments—a nurse will check the circulation and motion of your legs and feet. You may be given spirometer (sper-ah-ma-ter) (a blue tube you breathe into) to help expand your lungs and prevent pneumonia. Surgical tape, sutures, or adhesive tape will have been used to close your incision. This dressing may be removed and changed. An ice pack or cooling pad may be used to help decrease swelling and increase your comfort. It is common to continue intravenous (IV) fluids for the first day or two.
• Medications—you may be given antibiotics through your IV for the first 24 hours to help prevent infection. Pain medication will be made available to help relieve any pain or discomfort you may be having. During the first 24 hours after surgery, you will probably be given pain medications that are injected into your IV line or directly into your arm or buttock. Or you may have a PCA (patient controlled analgesia) pump. The pump lets you give yourself small amounts of pain medication. These medications are usually much stronger and faster acting than pills taken by mouth. Some pain is normal, even with medication. But if you feel very uncomfortable, tell your nurse. Treating pain before it becomes severe often means that you use less pain medication overall. It is important to keep your pain in check so you can participate in your rehabilitation program.
• Diet—how quickly you recover from anesthesia varies from person to person. Your diet will be ordered by your doctor at first, and it will be adjusted as your intestinal function gets back to normal. Usually you will be allowed to have clear liquids as soon as you are able to eat. If you feel okay after drinking clear liquids, you will be given food that is more solid. Special precautions will be taken if you had surgery from the front of your neck.
• Activities—your PT will work with you to begin moving safely in bed and up to a sitting position. Soon after surgery, you will be encouraged to get up and walk. This helps to keep your blood and bowels moving. It also keeps fluid from building up in your lungs. You will gradually progress to standing and walking. You may require the use of a walking aid (cane or walker) for a short time, and a brace to support your spine.. Your PT He or she may suggest exercises to relieve soreness in your legs, such as tightening and releasing your thigh and buttock muscles and pumping your ankles back and forth to keep fluid from pooling in the lower limbs and help prevent blood clots. Your PT may also teach you how to protect your spine while moving, including tightening your abdominal muscles to "brace" yourself and prevent pain and reinjury. To strengthen your abdominal muscles, practice this simple exercise:
  1. Put your hands on the lower part of your stomach
  2. Gently tighten your abdominal muscles by pulling in your stomach
  3. Breathe normally without relaxing your abdomen
• Tests—you may need to have blood checked every day if your doctor has placed you on blood thinning medications. These tests are needed to regulate anti-coagulant (blood thinning) therapy. During the first few days, your doctor will monitor your blood thinning level.

Day 2

By your second day in the hospital after spine surgery, you may expect the following:

• Treatments—your IV line may be removed. If you have a urinary catheter, that may also be removed. You will probably continue to use the spirometer to help prevent pneumonia, and your wound dressing may be changed or removed.
• Medications—it is natural to feel some pain during the first few days after spine surgery. The pain you may have can usually be controlled with medication, so let your nurse know if you are in pain. By Day 2, you will begin switching from medications given through injection, or your IV, or PCA to pills that can be taken by mouth. Taking medications by mouth will make things easier when you are ready to go home.
• Activities—it is important to continue doing the exercises that have been prescribed by your doctor or PT to help improve motion and keep your muscles from getting sore and tight. Ice packs may be applied before and after therapy treatments to reduce swelling and relieve pain. With assistance from your PT, you will gradually increase the distance you are walking in preparation for going home.

Day 3 and Beyond

• Treatments— your wound dressing will be changed if needed or removed.
• Activities—your physical therapy will continue to focus on safety with mobility, with the goal of enabling you to be independent. In spite of any mild discomfort, it is important that you do your deep breathing and exercises as instructed. Breathing and moving well will help improve your lung capacity and circulation, and may help you heal faster.

You will be able to return home when your doctor feels that your medical condition is stable. You may be instructed to limit your activities for a period of time to give your body a chance to heal. As you prepare to leave the hospital, be sure to follow the instructions given by your health care team.