Transcript Pre-Operative Education Guide for Spinal Surgery Patients

Pre-Operative Education
Guide for Spinal Surgery
Patients
The Spine
The spine stretches from the base of the
skull to just above the buttocks. It is
composed of 24 bones, called vertebrae,
that are stacked on top of each other.
In between the vertebrae are discs, which
provide cushioning and protection. They
are made of spongy material with a ring
of stronger material.
The bones of spine provide support for
the body and protect the spinal cord. The
spinal cord transmits information, such as
pain and other sensations, between the
brain and the body. The spinal cord is
also gives us the ability to move our body.
The spine is divided into five areas. The
vertebrae that make up these areas are
uniquely shaped to match their role in
supporting the body.
The cervical spine has 7
vertebrae
The thoracic spine has 12
vertebrae
The lumbar spine has 5 vertebrae
The sacrum is the base of the spine,
and consists of 5 bones fused
together
The coccyx is connected to the base
of the sacrum
Image from Fotolia.com
The Spine
Vertebra
Disc
Spinal Cord
In a healthy spine, the discs in the spine
lined up with vertebrae to provide
cushioning. Due to aging and injury the
discs may weaken, bulge or rupture.
Image from Fotolia.com
Spinal nerves run from the spinal cord to
other parts of our body. They come out of
the spinal cord in spaces between the
vertebrae. Spinal nerves carry information
between the spinal cord and the rest of
our body.
If a disc bulges or ruptures, the material
from the disc may press on the spinal
nerves, causing pain or decreased
sensation to other parts of the body.
Ruptured Disc
Spinal Nerve
Vertebra
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Spinal Nerves
Symptoms of
Cervical 6 and
7 nerves
Symptoms of
Lumbar 5 and
Sacral 1
nerves
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Spinal nerves provide sensation and the ability to move different parts of the body.
This diagram shows how symptoms of pain, numbness or weakness in the arm or leg
may be related to problems in the spine.
Surgical Procedures
If symptoms are due to a ruptured disc, the
surgeon may be able to make a small
incision and remove the disc material that
is pressing on the spinal cord or spinal
nerves. This is called a discectomy.
Sometimes removal of a portion of the
vertebrae is necessary to relieve
symptoms. This is called a laminectomy.
Sometimes the vertebrae are weakened
because of injury and disease, and a spinal
fusion procedure is recommended to take
pressure off of spinal nerves and to
improve the structure of the spine.
Image from University of Florida
Neurosciences Department
The disc between the fused
vertebrae is removed, and
bone graft is placed between
the vertebrae.
Rods and screws are used to
support the fused vertebrae,
and additional bone graft may
be used to help with healing.
Image from Fotolia.com
Spinal fusion stops movement in
areas of the spine, reducing pain
and increasing your ability to
function. In addition, the height of
the damaged disc is restored.
Regular exercise and physical
therapy will be important to your
recovery.
Pain
Pain is normal following surgery. Post-operative pain often feels different from the
chronic pain you have been experiencing from your spine problems. Pain may be
caused by the incision, swelling and muscle tension. Be sure to tell your doctor
what pain medications and dosage you are taking before your surgery, so that we
can be more effective in controlling your pain.
Pain medications are given to reduce pain; unfortunately it is not possible to be
pain-free after any type of surgery. You will be asked how bad your pain is using a
scale from 0 to 10. A “0” means no pain, while a “10” means the worst possible
pain. The diagram below shows a pain scale:
Image from GeriatricPain.org
It is important to keep pain controlled as well as possible. If you are in too much
pain it will be difficult for you to walk and participate in physical therapy. Experts at
the Cleveland Clinic have found that good pain control reduces the amount of time
needed to recover from surgery and may reduce the risk of surgical complications.
Pain
Fortunately there are many methods used to provide relief from pain, including:
•
Repositioning and early ambulation
•
Heat/ Cold packs
•
Relaxation
•
Medications
• Acetaminophen
• Narcotics or opioids (Percocet, Norco, Morphine, Dilaudid)
• Muscle relaxants (Flexeril, Valium)
• Medications for nerve pain (Lyrica, Neurontin)
Narcotic pain medications can be very beneficial but may cause side effects such
as constipation and nausea. Stool softeners are prescribed after surgery to help
prevent constipation. Walking and drinking water will also help. Taking narcotic
pain medications with food will help prevent nausea.
Narcotic pain medication may cause itching, which may be relieved by Benadryl.
Excessive sleepiness can be caused by narcotics, and decreasing the amount of
medication may be helpful.