Recovery from cervical spine surgery is a gradual process that varies from patient to patient, and depends a great deal on the specifics of the procedure. As one might expect, patients who undergo simpler procedures typically heal much faster and are able to return to prior activities more quickly. Patients with repeat and/or more extensive procedures can expect a longer recovery. Most patients experience significant progress during the first 2 to 4 weeks.
In the majority of cases, patients experience immediate relief from arm pain. Others may have significant relief initially, with ongoing improvement over the ensuing days to weeks. Numbness resolves more slowly and sometimes less completely than pain.
Midline neck pain also begins to improve shortly after surgery. Patients with significant pain in the muscles moving out of the neck, as well as towards the shoulder and shoulder blades, may find that this type of pain can be a little slower to resolve. Oral medications taken while the patient is healing usually do an excellent job at controlling this unresolved pain, as well as any discomfort resulting from the incision.
In many cases, patients may also be given oral medication for the muscle spasms that can accompany spine surgery, or for the occasional bout of nausea.
Although all patients will experience some degree of a sore throat from the breathing tube necessary when providing general anesthesia, patients who have an anterior (front of the neck) approach will have a sore throat for a longer period of time. Similarly, patients who have had surgery to the front of the neck may experience difficulty with swallowing, although chewing food slowly and thoroughly usually takes care of the problem.
The healing process begins the day of surgery, and we encourage patients to try and walk that evening. Being mobile is key to the recovery; no one gets better until they start getting active.
Patients should strive to increase their activity level every day, being as active as possible without becoming winded or breaking a sweat. Patients need to remember that there will be some good and some not so good days, and that this is a normal part of the healing process.
For the first month, the primary exercise should be walking. It is best to walk a short course multiple times. For example, patients who live in the cul-de-sac may walk around the cul-de-sac as few as two times or as many as 200 times, and at most need only to cross the cul-de-sac to get home. Similarly, those who have a long driveway can just walk up and down the driveway. The important thing is to avoid getting too far from home in case they start to feel sore or fatigued.
The importance of good posture cannot be overstated. This does not mean that the patient has to stay completely rigid; however, it is necessary to sit or stand tall with the head held high. Some patients will have to wear a rigid collar, both to help the bone heal and to give the muscles extra support. On an as-needed basis, other patients may utilize a soft collar to remind them to limit extreme movements and to maintain good posture.
It is also very important to eat properly. The body needs fuel and vitamins in order to heal. For diabetic patients, proper nutrition and careful control of glucose are especially important.
Most patients have a brown strip of paper over their incision and under the hospital bandage. Bandages similar to that most superficial bandage can be bought at a local drugstore and changed as needed. It is important to keep the incision covered and out of direct sunlight. The brown strip of a paper that directly attaches to the skin helps with the cosmetics of the closure. If it has not fallen off in the shower after seven to ten days, peel it off gently.
Patients may shower three days after surgery. Let warm soapy water wash over the incision, but do not scrub that area and do not aim the water stream directly at the incision. Pat dry gently. Until the incision is completely healed, treat it as gently as the skin of a newborn child. Do not immerse the incision until the skin is completely healed.
In all but a few cases, driving should be completely avoided for the first month. It is important to note that it is illegal to drive while under the influence of narcotics or the other controlled substances that are taken for pain following spine surgery. We also recommend keeping the amount of time in a car as a passenger to a minimum for the first month.
Do Not Smoke
Smoking is a serious problem for patients recovering from surgery. For patients who undergo fusion, smoking interferes with bone healing, causing smokers to have a higher rate of failed fusion than the general population. As a result, smokers are more often required to undergo additional procedures (including the use of a Halo.) For patients who don’t undergo fusion, smoking can interfere with wound healing, which can put them at higher risk for infection.