Transcript Spine education 10.08 - Doctors Hospital of Augusta

Pre-admission
Spine Surgery Education
Preparation
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Surgery
Recovery
Understanding your spinal procedure
Preparation for surgery
Day of surgery expectations
Discharge Instructions
Recovery Process
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7 Cervical
12 Thoracic
5 Lumbar
Sacrum and Coccyx
Provides us strength
Allows us to stand
Supports our weight
Passageway for
spinal cord and
nerves
Laminectomy
Creation of a “window” in the vertebrae. This
allows more room for nerves and releases pressure
on the nerve
Discectomy
Creation of a “window” in part of the outer
ring of the disc. This allows removal of a
portion of the disc nucleus releasing the
pressure on the nerve
Fusion
A graft ( bone or bone protein material) placed
between 2 or more vertebrae. Provides stability
to the spine- many times screws are used to
maintain stability while healing occurs.
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How fusion is done
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Bone Graft
Immobilization
Types of fusion
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Posterolateral
Interbody
 ALIF
 PLIF
 TLIF
 XLIF
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Obtain all required pre-admission testing
recommended by surgeon and bring
information to Pre-Op (may include blood
work, EKG, chest x-ray, medical clearance
from primary doctor, or self-donated blood)
Clear all medications with your physician,
including any herbal substances or nutritional
supplements you may be taking
Bring All insurance cards & picture
identification to Pre-Op
Do not eat or drink after midnight the night
before your surgery
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Personal care items (such as toiletries)
Rubber soled / non-skid shoes or closed back slippers
Comfortable clothing for therapy
Loose fitting pajamas and /or light weight robe
Bedside snacks
Important contact phone numbers
List of medications, including the ones you may stopped prior
to surgery, dosing information
Eyeglasses instead of contacts
Dentures / hearing aids if needed
Brace if you have one and are asked to bring it
Walker or cane if used at home
Important: Leave all valuables at home!!!
General Health Guidelines
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Weeks before the surgery, you should
concentrate on the following:
Nutrition
Eat healthy
Drink plenty of fluids
 Do not drink alcoholic beverages
 Stop smoking
 Take your daily medication as directed by
your physician
 Discuss with your physician any nutritional
and/or herbal supplements you are taking
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Pre-operative shower
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Take the evening before or day of surgery
Wash with Triseptin soap provided at pre-op
Do not eat or drink after midnight
As directed by your physician, take required
medications with a sip of water only
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Your specific surgical time will
be determined at your pre-op
visit
Report to the Main Lobby at
the time appointed in your preop visit
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Surgery will last 1-2 hours
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Time in the recovery room is
generally 1-2 hours
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During surgery your family
will wait in the surgical
waiting room
After recovery, you will be
transferred to the nursing unit
on 2 South where family
members can see you
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Following your surgery, you may have:
Intravenous therapy (IV) to provide fluids,
medication and/or antibiotics
 Drain at your incision site which prevents fluids
from building up
 Urinary catheter to help drain your bladder
 Foot pumps to prevent blood clots
 Incentive spirometer to help with deep breathing
exercises
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You will see anesthesia
at your pre-op visit
General anesthesia or a
spinal anesthetic will be
administered during
surgery
Pain relief options after
surgery include:
Epidural anesthesia
Patient controlled analgesia
(PCA) pump
 Injections (as needed)
 Oral medications (as needed)
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10
Worst possible pain
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8 Very severe pain
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6 Severe pain
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4 Moderate pain
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2 Mild pain
1
0 No pain
Leg
exercises and support stockings (TEDS) or
foot pumps help keep the blood flow in your
legs moving and to prevent blood clots (DVT)
How it happens….
Ways to help prevent it…
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During your first day of recovery, you may have
or begin:
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Lab tests
Intravenous (IV) fluids, catheter and/or your
drainage tube removed
Your dressings or bandages changed
To turn, ambulate, deep breath and use your
spirometer
Dressing and bathing activities
Physical and Occupational Therapy
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Working with physical/occupational
therapy to participate in walking,
exercise and daily living activities
programs
Working with a Case Manager or
Nursing staff to prepare you for the
next level of care, your discharge
location and any equipment needs
Take pain medication as needed in
order to participate with therapy
Roll your entire body
instead of twisting at the
waist
Once on your side, ease
your legs off the edge of
the bed to sit up
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Depending on your surgery, your recovery
progression and your surgeon will determine if
additional days are required in the hospital.
During your second day in the hospital you
will
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Continue to work with physical and/or occupational
therapy
Continue to deep breath and use your spirometer
Continue to discuss discharge planning
Take your pain medication as needed
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You will be discharged from
the hospital when you are
able to:
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Eat and drink to prevent
dehydration
Empty your bladder without
any problems
Effectively manage any pain
Increase your mobility
(walking and exercising)
Have bowel movement
without complications
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Your physician, nurse, or physical therapist
will discuss the following:
Spine precautions and special instructions
 Pain control and prescriptions
 Signs of infection or problems
 Bandage changes and care of incision site
 Approval for driving, sexual activity, and any other
physical activities
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Proper lifting techniques
No bending or twisting back
 Keep back straight
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Limit sitting in upright chairs to 10-15 min
Log rolling to get in and out of bed
Do not lay on your stomach
Further instructions will provided at your postoperative physician appointment.
Recovery
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Make modifications to your home prior to
surgery that will decrease your risk for falls or
injury
Home Safety Tips…
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Remove or tack down throw rugs
Remove clutter from hallways
and walkways
Keep electrical and telephone
cords safely out of sight (Use
cordless phone, if possible)
Rooms and hallways are well
lit for visibility
Safety and grab bars are installed
as needed
Keep items in the
kitchen/bathroom
at waist level for accessibility
Arrange pet care, if needed
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Things to keep in mind:
Keep your incision clean and dry
 Shower with mild soap and do not put any creams on
your incision
 Take your medication as prescribed
 Progressively increase activities as directed
 Use proper lifting techniques. Do not lift anything
heavier than a light bag or book
 Sit in a supportive chair with arms
 Keep your walking areas free of clutter
 Keep moving!!
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If prescribed by your physician, a case
manager / nurse / therapist will
educate you on the use of these
assistive devices:
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Canes
Rolling Walkers
Elevated commode seats
Bedside commode or 3 in 1 commode
Back/neck braces
Pillows to be used when sleeping
Ankle pumps
Reacher
Sock aid
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Chest pain or difficulty breathing – Call 911
Sudden inability to move your leg(s) – Call
911
Fever above 101°
Pain in your back, NOT relieved by
medication
Unusual redness, heat or drainage from your
incision site
New numbness/tingling in your leg(s)
Changes in bowel or bladder
To avoid infection:
 Antibiotics
To Avoid Blood clots:
 Anticoagulants
 Foot Pumps
To Avoid Heart Attacks:
 Talk with your doctor
about your
medications
Courtesy
of the Surgical Care Improvement Project Partnership (SCIP)
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To avoid pneumonia
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Pneumonia vaccine is available, if ordered by your
physician
Early mobilization (or getting out of bed)
Incentive Spirometry
To avoid flu
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Flu vaccine is available, during flu season, if
ordered by your physician
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Precautions are taken prior to and during
surgery to reduce risk
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Smoking increases risk. Ask us how to quit!
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Make sure your doctor and healthcare
providers wash their hands or use sanitizer
before exams, ask “Did you wash your
hands?”
Clean your incision based on your discharge
instructions daily until follow-up with your
doctor
Call your Doctor if you have any signs or
symptoms of infection (redness, increased
pain, increased drainage, fever)
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Thank you for reading through this
presentation. If you have any questions, you
may call our Human Motion Institute Spine
Line at 706-651-2449.