Post-Spinal Surgery Concerns: Recovery, Complications, and Future Work

Q: Post-Spinal Surgery Concerns: Recovery, Complications, and Future Work

Hello： 1. Lifting heavy objects, standing for long periods, and squatting for extended durations can harm the lumbar spine and increase your risk of recurrence. It is advisable to adjust the nature of your work. 2. You will not become incapacitated. After the

Post-operative issues related to spinal surgery (sequelae, functional roles, uncertain recovery status)

Hello Doctor, I suffered a burst fracture of the lumbar spine at L3-L4 at the end of June.
Due to the loosening of the screw at L4, I need to return to the hospital for surgery next week.
The attending physician mentioned that the screw needs to be extended down one more segment to increase stability.
I have several concerns regarding potential sequelae and my future work:
1.
My original job is construction-related, which requires lifting heavy objects, prolonged standing, and squatting.
Is there a chance I can return to my previous job?
2.
After the fixation of three segments of the lumbar spine, does this mean that my back will be essentially non-functional like that of an elderly person, making it difficult to bend or move?
3.
Will I still have the opportunity to engage in physical activities or exercise?
4.
I found information online stating that spinal fixation can lead to increased stress on adjacent segments.
Does this imply that I will inevitably need further surgery in the future?
5.
Since I have sustained nerve damage, I initially experienced mild foot drop, numbness, and weakness in my right leg.
I also had to exert significant effort for bowel and bladder movements, and my sexual function has been affected, with difficulty maintaining an erection.
Currently, after three months, my right leg has shown some improvement, and there has been slight progress in bowel and sexual function, but the improvement is minimal.
Is there still room for further recovery in these areas, or has the maximum recovery already been reached after three months?
Thank you, Doctor.
I apologize for the numerous questions.

Niming, 20~29 year old female. Ask Date: 2023/10/06

Dr. Lai Zhaokang reply Neurosurgery

Hello: 1.
Lifting heavy objects, standing for long periods, and squatting for extended durations can harm the lumbar spine and increase your risk of recurrence.
It is advisable to adjust the nature of your work.
2.
You will not become incapacitated.
After the fusion of the spine, you can still bend, but there will be slight limitations in range.
3.
You can certainly exercise.
4.
There is no definite timeline; it depends on your subsequent care.
5.
There is room for improvement; please continue with rehabilitation, medication, acupuncture, and maintain an optimistic mindset.
You may also consider combining it with hyperbaric oxygen therapy.
6.
You are only 20 years old, and life is still long ahead.
The medical technology for nerve repair and regeneration is advancing, and you can look forward to that day with optimism.
By Dr.
Lai Chao-Kang, Chief of Spine and Neurosurgery at Changhua Hospital.

Reply Date: 2023/10/06

More Info

Post-spinal surgery recovery can be a complex and multifaceted process, especially after significant procedures like the one you are facing. Your concerns about returning to work, the implications of spinal fusion, and the potential for future complications are all valid and important to address.

1. Returning to Work: Given your previous job involved heavy lifting, prolonged standing, and squatting, it is crucial to have a thorough discussion with your orthopedic surgeon and possibly a rehabilitation specialist. After spinal fusion surgery, the ability to return to such physically demanding work can be limited. The surgery aims to stabilize the spine, but it also means that certain movements may be restricted to prevent further injury. Your doctor may recommend a gradual return to work, potentially with modifications to your duties to accommodate your recovery and prevent strain on your spine.

2. Impact of Spinal Fusion: It is a common misconception that spinal fusion renders the spine "useless" or akin to that of an elderly person. While it is true that fused segments of the spine will not have the same range of motion as non-fused segments, many patients can still lead active lives. You may experience limitations in bending and twisting, but this does not mean you cannot use your back at all. Physical therapy will be essential in helping you regain strength and learn how to move safely.

3. Opportunities for Exercise: Yes, there is still a chance for you to engage in physical activity post-surgery. However, the type and intensity of exercise will need to be tailored to your condition and recovery stage. Low-impact activities such as swimming, walking, and specific strength training exercises designed for spinal health can be beneficial. Always consult with your healthcare provider before starting any exercise regimen.

4. Future Surgeries: It is true that spinal fusion can lead to increased stress on adjacent segments of the spine, which may predispose them to degeneration over time. However, this does not guarantee that you will need further surgery. Many patients live without significant issues for years after fusion. Regular follow-ups with your healthcare provider and maintaining a healthy lifestyle can help mitigate these risks.

5. Neurological Recovery: The improvement you have seen in your right foot and other neurological symptoms is encouraging. Recovery from nerve injuries can be slow and varies significantly from person to person. While some patients see substantial improvement within the first few months, others may continue to recover over a longer period. It is essential to maintain realistic expectations and continue working with your healthcare team to monitor your progress. They may recommend physical therapy or other interventions to support your recovery.

In summary, while your concerns are valid, many patients successfully return to fulfilling lives after spinal surgery. It is crucial to maintain open communication with your healthcare providers, adhere to rehabilitation protocols, and be patient with your recovery process. Each person's journey is unique, and with the right support and management, you can work towards regaining your strength and functionality.

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