Posterior Cervical Decompressive Laminectomy

Patient Management

POST OPERATIVE CERVICAL SPINE SURGERY INFORMATION SHEET

Posterior Cervical Decompressive Laminectomy

GENERAL ADVICE

Give yourself adequate time to recover over the next few weeks. Take things slowly and you will feel better off down the track. In this early recovery phase your body benefits from lots of rest and good nutrition. Don’t try to rush back into your pre-operative routines; these can be gradually re-established over the next 4-8 weeks.

WOUND CARE

  • The sutures in the back of your neck are all below the skin surface and fully dissolvable.
  • Change the dressing on a daily basis for a few days, then leave open if comfortable.
  • The Nurses will also talk to you about wound care for when you go home
  • Let Mr Brendan O’Brien know through the rooms or the St Vincent’s Hospital if there is any:
    • Increasing wound redness, swelling or drainage
    • Increasing wound Pain
    • Fever or temperature > 38.0
    • For a low grade fever -record the temperature at 8am 12md and 6pm and notify

Remember: Increasing Pain is a RED FLAG

MOVEMENT / EXERCISE REGIME

  • IMPORTANT TO AVOID BENDING, TWISTING, PUSHING, STOOPING OR LIFTING anything you are not comfortable with.
  • Get up from a lying position by first turning onto one side.
  • Don’t lift both arms over your head at once.
  • Initially limit sitting to an upright posture for 30mins at a time, 4 times per day (usually aligns with mealtimes). Avoid lying on the sofa use the bed instead.
  • Begin walking in the house then progress to outdoors.
  • Gradually increase the distance you are comfortable with.
  • Start at approximately 10-15 minutes 2-3 times per day, if you are up to it.
  • Increase gradually over the first few weeks.
  • Exercises from the physio are very helpful but more so after the first few weeks.
  • If you feel increased soreness or discomfort – REST
  • Resumption of sexual activity: generally this is over the first four to six weeks, being careful to avoid unusual strain or positioning.
  • By the fourth week try to walk 2-3 times per day for 20 mins each at a comfortable pace

REMEMBER: THESE ARE GUIDELINES TO EXERCISE – NOT RULES

DRIVING / GENERAL ADVICE

  • It is advisable not to drive from time of discharge until reviewed in Rooms
  • This is around four weeks post-operative
  • Alcohol intake is okay but should be limited to two glasses at any one sitting
  • Make all efforts to refrain from smoking as this definitely delays healing and bone fusion

MEDICATIONS

On discharge you will be on some medications (apart from your regular ones

  • Analgesics
    • This is usually paracetamol/codeine combinations, tramadol or oxycodone, you will find the doses can be gradually decreased over the first few weeks; others used may be endone or long acting paracetamol
    • As a general rule take regular pain relief (eg every 4-6 hours) to avoid any pain rebound
  • Anti-inflammatories
    • These can be continued if prescribed, over the first few weeks, as needed
    • Cease if there is any indigestion or heartburn

ADVERSE OR UNEXPECTED SYMPTOMS after Discharge: What to Notify?

Notify Mr Brendan O’Brien if any of these occur or you become worried about:

Procedure Related:

  • Wound or wound care issues
  • Changes or new difficulty swallowing or talking

General:

  • Fever, chills
  • Cough, shortness of breath
  • Calf or ankle swelling
  • Pain passing urine

RETURN TO WORK

  • This should be delayed until you are reviewed in the rooms.
  • Some light sedentary computer work can be done from home if you must!
  • Avoid the temptation to do the housework, paint the kids room or clean up that back shed.
  • Please let us know if we can give you any required sick certificates before discharge.
  • Any necessary workcover certificates can be arranged through the rooms.

FOLLOW UP APPOINTMENT

You will be given a review appointment with Mr Brendan O’Brien for approximately four weeks after discharge.

If you are discharged on a weekend, please call the rooms the next Monday for an appointment.

Please encourage your GP to contact Mr Brendan O’Brien at any time if he wants to discuss any concerns that arise in your care or progress.