These are general guidelines for recovery from scoliosis surgery.
At the Hospital: Immediately Following Scoliosis Surgery
Pain Management — Just after scoliosis surgery, most patients are given PCA (patient-controlled analgesia). PCA is a pump that delivers morphine or other narcotic at the press of a button by the patient. This controls pain very well for the first two to three days after surgery. Thereafter, PCA is stopped and oral pain medication is administered. At hospital discharge, a prescription for pain medication is provided. Adults may require medication at diminishing doses for weeks or months. Children are usually off medication within two weeks.
Drains — A drain prevents fluid accumulation at the incision site and is routine. Most patients have a drain in their back or side for two to three days after surgery. Drains in the side of the chest are termed ‘chest tubes’ and prevent air and fluid from accumulating around the lungs. Drains are removed when fluid drainage is small. Drain removal is not painful.
A urinary catheter (Foley) helps to keep the patient comfortable. It may be removed two or three days after surgery.
Walking — Physical therapists and nurses help the patient out of bed on the first or second day after surgery. Walking is guided by the physical therapist and is increased daily as tolerated.
Some patients may need a walker or cane early during recovery to help with balance and prevent a fall. keep their balance. Most children do not need walking aids at home.
Eating — Most patients will not begin to eat for two to three days after surgery. This is because the bowels slow down after surgery and patients have difficulty keeping food down.
Patients start on a diet slowly, first with sips of clear liquids, and move on to solid foods and a regular diet. Once home, it is important to eat well; small frequent meals are best to maintain body weight.
Before release from the hospital, patients must:
- Be eating a regular diet
- Urinating normally
- Walking, including up and down stairs
- Have no fevers
- Have minimal drainage at the incision site(s)
Some patients, especially adults, may benefit from a one- to three-week stay at an in-patient rehabilitation facility to improve walking and overall function.
At Home: Scoliosis Surgery Recovery
Helpful aids include an adjustable bed, shower chair, elevated toilet seat, and extended grasper are for use at home after surgery.
Incision care — Patients may begin to shower one-week after surgery. Before showering, tape plastic wrap to cover the incision. Remove the tape and plastic wrap after each shower. This should be done for showers taken during the first week at home. Thereafter, shower without the plastic wrap covering the incision. For safety, it is important to be accompanied in the shower for the first two to three weeks.
If there is a dressing on the incision, change it once a day until there is no staining of the sterile gauze. Thereafter, a dressing is not needed.
Steri-Strips are usually placed across the incision(s) and will fall off on their own. Do not remove the Steri-Strips unless instructed to do so or if they are dangling.
Respiratory Function — Lung (pulmonary) function may slightly decline after scoliosis surgery. To improve breathing function steadily with time, it is helpful to perform respiratory exercises every one to two hours for the first three weeks after surgery. Respiratory exercises include deep breathing using the incentive spirometer provided at the hospital and frequent coughing. Lung function is routinely checked during regular office visits.
Activity Level — Patients are encouraged to walk. However, bending, lifting, and twisting are usually prohibited for several months or until the surgeon approves. Sports are not allowed for at least three months after surgery.
When activities are resumed, it is recommended to return gradually. Conditioning exercises such as swimming, bicycling, treadmill, or jogging are a good way to start.
After full healing, most patients will not have activity restrictions. However, certain sports activities such as gymnastics may not be practical. Activities that may be prohibited will be discussed by your surgeon and are dependent on the extent of your spinal fusion. Most patients do not feel restricted.
Medication — Usually, nonsteroidal medications, such as aspirin, Motrin, and ibuprofen are prohibited. Tylenol can be taken. Birth control pills are stopped prior to surgery as these may increase the risk of blood clot formation during the postoperative period in women.
Smoking — Smoking impairs bone from healing and hinders fusion. Patients must be committed to stop smoking two months before surgery and for a minimum of six months after surgery. Of course, it would be better just to give up the habit for a lifetime.
Transportation — Avoid frequent car rides and mass transit for six weeks after surgery. Patients can go home from the hospital by car with a pillow behind their back and seatbelt in use.