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Posterior Cervical Foraminotomy / Spinal Rhizolysis

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 your neck are all below the skin surface and are 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 wound pain or soreness 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 until advised, after review in Mr O’Brien’s Rooms.
  • Usually driving is avoided / prevented for 12 weeks.
  • Alcohol intake is best avoided until review as it may interact with other medications.
  • Make all efforts to refrain from smoking as this definitely delays healing and recovery.

Medications

On discharge, you may be on some additional medications (apart from your regular ones)

  • Anti-Seizure medication
    • Phenytoin, carbamazepine or sodium valproate are the common ones used.
    • These will continue for 6-12 weeks and blood levels will be monitored as needed.
    • Continue to take them as regularly prescribed.
    • Notify any potential side effects: skin rash, drowsiness, unsteady walking.
    • Any seizure (general or partial) needs to be reported as this can affect your ability to drive and your medications may need to be altered to control them.
  • Analgesics
    • This is usually paracetamol/codeine combinations, tramadol or oxycodone, you will find the doses can be gradually decreased over the first 10-14 days; others used may be endone alone or in association with long acting paracetamol. As a general rule take regular pain relief (eg every 4-6 hours) to avoid any pain rebound. If headaches increase this may be a sign of increasing swelling and must be reported.
  • Dexamethasone
    • This may be used to decrease brain swelling (odema) or to prevent swelling from occurring.
    • This should be continued regularly when prescribed, over the first two weeks. The dose is then decreased gradually over this time. Notify us if there is any increasing indigestion or heartburn.
    • Importantly this should not continue over two weeks unless specifically requested.

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: when appropriate

  • 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.

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.

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