Rehabilitation after surgery for spinal disc herniation – the implications and complications
The Operation on an intervertebral disk is not the end of the treatment of intervertebral hernias. So the man returned to normal life, need a recovery period and intensive rehabilitation. In some cases, after the surgery, develop complications, although the development of medical equipment their number is minimal.
Possible complications after removal of herniated discs
Complications can be divided into intraoperative and postoperative.
Intraoperative develop during the operation depending largely on the skills of the operating surgeon, the operating procedure of tools is manipulation. Impacts from operations on the vertebral hernia are different.
There are two main complications:
- nerve Damage. In the immediate vicinity of the intervertebral hernia, usually, is the root of the spinal nerve, compression of which causes the clinical picture of the hernia. When discectomy may cause unintended damage of the spine. In the postoperative period, this fact will be manifested by impaired sensation or muscle weakness in the corresponding leg (paresis and paralysis).
- Damage to the Dura mater. Noticed the gap immediately closed by the neurosurgeon, if the gap is not seen in the postoperative period may develop intense headaches due to the permanent leakage of cerebrospinal fluid from the spinal canal, accompanied by a decline in intracranial pressure. These effects can persist up to several weeks to self-healing of the Dura.
Postoperative complications
- Early:
- purulent-septic complications (local – epidurit, osteomyelitis and pneumonia, sepsis);
- of thromboembolic complications (pulmonary embolism, venous thrombosis of the lower limbs).
- Late:
- the recurrence of vertebral hernia is the most frequent complication. According to various sources ranges from 5 to 30% of all operated hernias;
- scar-adhesions in the lumen of the spinal canal associated with pain caused by a pinched nerve with scar tissue.
To Reduce the likelihood of late complications after surgery on the disc and to achieve a good quality of life will help you comply with the recommendations of the doctor in the recovery period and quality rehabilitation.
Rehabilitation after surgery for herniated spinal
Immediately after the operation the person feels great relief – decreases pain, restores function of the pelvic organs and lower limbs. However, it is worth remembering that without rehabilitation treatment can not do. During the recovery period after removal of the hernia is underway to consolidate the achieved results, adaptation of the spine to the new conditions, the formation of a new vertebral biomechanics.
Conventionally, the recovery period can be divided into three stages:
- the first man performs a number of recommendations aimed at prevention and suppression of pain;
- on the second – human adaptation to everyday life;
- the third is a set of activities whose primary purpose is the full restoration of biomechanics of the spine, prevention of recurrence of disc herniation, strengthening the musculoskeletal system and return to normal life.
depending on the severity of surgery and volume restoration period lasts from 4 to 12 months, on average occupying about six months.
Recommendations in the early postoperative (recovery) period:
- within 1-1,5 months after surgery not to sit in order to avoid early recurrence of the hernia and compression of the nerve root;
- to Avoid sharp and strong movements involving the spine – bending forward and sideways, turns with twisting of the spine;
- Ride in a car or other form of transport just as passenger on the unfolded seat, into a reclining position;
- Avoid lifting heavy items – the maximum weight of 3-4 kg in each hand;
- Every 1.5-2 hours to rest the spine to lie within 15-25 minutes;
- to Wear semi-rigid corset. For training of the spine wearing time is limited to three hours a day.
To accelerate the processes of reparation (recovery) during this period, it is possible to recommend methods of physical therapy effects: laser therapy, diadynamotherapy, sinusoidal modulated currents, electrophoresis in the spinal area.
For the relief of pain using non-steroidal anti-inflammatory drugs.
In General,early rehabilitation after removal of a hernia can be described security mode – during this time the scar was healing, the inflammatory process abates. You can then move on to more intensive rehabilitation.
Intensive rehabilitation in the postoperative period
The delete operation of hernia by the open method the patient is discharged from hospital in 3-4 weeks, and endoscopic discectomy – in 1-2 weeks. From the second month you can start intensive rehabilitation, including prevention of intervertebral hernia.
At this stage in the rehabilitation program included physical therapy, rehabilitation exercises. These procedures are best done under professional guidance. The best option is the passage of a Spa treatment. In sanatoria run by experienced instructors physical therapy, there are swimming pools – swimming recovery period is of great importance.
If unable to get to health resort or rehabilitation centre, you can use video tutorials – many of the developers of restorative programs are publishing video lessons on the Internet.
Here is a small set of exercises rehabilitation exercises for independent performance:
- In the supine position slowly bend your legs, trying to press her knees to her chest. Relax your glutes and try to hold this position 45-60 seconds. Slowly straighten your legs.
- Lie on your back, spread his hands. Legs bent at the knees and leaning on them to lift the hips. To hold the first 10-15 seconds. Gradually increase the time to 60 seconds.
- Position on the back. His hands are clasped behind head, legs bent at the knees. Rotate the feet, the knees trying to get the floor – left and right. The upper torso should stick out horizontally.
- starting position – leaning on hands and knees. At the same time pulling the opposite arm and leg horizontally and hold for 5-10 seconds so – replaceable legs with his hands. The exercises increase to 45 to 60 seconds.
- Lying on his stomach, hands under the chin. Slowly raise the extended leg up without lifting the pelvis off the floor, lower your leg. Repeat the exercise with the other leg.
In addition to gymnastics rehabilitation after surgery for intervertebral hernia, it is recommended to undergo sessions of acupuncture.
Late period recovery
After 6-8 months after surgery on the intervertebral disk under the supervision of a physician, you can begin to rebuild the muscle corset. Activity exercises to strengthen the back muscles is greatly increased.
during this period in the comprehensive treatment added treatments of manual therapy and massage at least twice a year. These procedures allow you to completely restore circulation in problem area, refer the patient to an active way of life and to prevent recurrence of a herniated disk after its removal.
It is Not recommended to lift the weight more than 5-9 kg, jump, long sit or stand.
Going outside, do not allow overcooling of the back to the lumbar region should be worn as a warm zone. It is necessary to abandon the wearing of a corset strengthening to avoid muscle atrophy.
Recovery in the postoperative period is difficult. Do not be upset or discouraged if something does not work immediately. Need to work on your will power and your health depends. And doctors will gladly help.