Back surgery

Together with your attending spinal surgeon you have decided to undergo back surgery. In the following, you will find the most important next steps.

As a rule, an appointment will be made for you to go over the various preparations required before your surgery, including a final in-depth discussion with your surgeon. This will give you another opportunity to receive all the information you need about the procedure and to ask questions about the operation. You will also be told about which medication you may need to stop taking before the procedure. There will also be a meeting with the anaesthetist, an admission meeting with the attending ward doctor, and laboratory investigations. Occasionally, further investigations, such as an electrocardiogram (ECG) or a pulmonary function test (PFT), are also necessary. Depending on the procedure, you may receive a prescription for skin treatment (medical skin cleanser). You can obtain any medicinal products we prescribe from our in-house pharmacy. Our case management team will organise any necessary therapeutic follow-up treatment, e.g. at a rehabilitation clinic.

In most cases, you will be admitted on the day of your surgery. The nursing team will welcome you to the ward and inform you about the inpatient procedure. In accordance with the specifications of the anaesthetists, you should generally be in a fasted state, i.e. you should not eat anything for six hours and not drink anything for three hours before the procedure.

After your surgery, you will be taken to the recovery room for monitoring. If necessary, you will be monitored on the Intensive Care Unit. If you have agreed it with your surgeon in advance, a contact person named by you will be informed of how the surgery went after the procedure.

As soon as it is no longer necessary to monitor your vital parameters, you will be transferred to the ward. In most cases, you will already be allowed to get up on the day of your operation, although you will need support from nursing staff or therapy specialists. In some cases, however, bed rest will be prescribed. During your inpatient stay, you will be cared for by physiotherapists, and the attending ward doctors and your surgeon will see you regularly during their rounds. Your wound will also be checked at regular intervals. If necessary, you will be supported by a specialist from the Centre for Pain Medicine to ensure ideal pain management. Depending on the course and the procedure, it may be necessary to take blood once or several times. An X-ray check-up is often required in the days following your surgery.

Your discharge will be planned during the regular doctors’ rounds It will take place at the earliest when the surgical wounds are dry, you no longer need intravenous medication, and are relatively mobile on your own. If you are going to undergo further treatment in a rehabilitation clinic, the case management team will inform you of the procedure. Before you are discharged, you will have a discharge meeting with the ward doctor. This is where you will be informed about the further procedure and given your discharge paperwork. You can use a checklist to make sure you have all the documents you need.

• Discharge report
• Certificates (inability to work, gym)
• Prescription (pain relief)
• Behavioural measures
• Possible aids
• Spitex nursing and care services

You have undergone back surgery. Pain is normal after this procedure. It is generally caused by tissue irritation and/or is an expression of muscle tension. Please take the pain medication prescribed to you in accordance with your prescription. Local cooling may also help. Please contact your GP if the pain does not abate.

At the time of your discharge, your wound will be dry and covered with a fresh dressing. It should be checked regularly. If the wound has not healed fully, please make an appointment for a wound check-up with your GP in the first or second week after you are discharged. You may shower with a waterproof shower plaster. Please do not have a bath or go swimming in the first three weeks. Depending on the type of sutures, they will either dissolve or will need to be removed by a medical professional as stated in your discharge report. If the wound starts to weep and surrounding tissue becomes red and swollen, please contact us or your GP.

Permitted weight-bearing and suggested physiotherapy exercises will be discussed in your discharge meeting and in your discharge paperwork. “Back-appropriate” weight-bearing is generally allowed if nothing else has been prescribed. This “back discipline” means that you may go for walks and can also climb stairs if possible. Please ensure that your posture is upright when you sit. Avoid lifting anything that weighs more than 5 kg until the first follow-up appointment with your surgeon. Also avoid excessive twisting movements and, depending on the area that was operated on, excessive bending of the neck or torso. Speak to your surgeon if you are uncertain.

Depending on the procedure, you may be given a prescription for outpatient physiotherapy follow-up treatment. This is not required for all procedures. As a rule, you may perform the exercises you were shown during your inpatient stay two to three times a week at home. Our physiotherapy team will be happy to give you an exercise plan. You may also do your outpatient therapy in the Swiss Paraplegic Centre. After spondylodesis (stiffening operation), we recommend that you wait to start weight-bearing in physiotherapy until after your first follow-up check.

We basically recommend that you do not drive yourself before your first check-up. Your seating comfort and your reaction time may be impaired due to the procedure on your spine and due to pain medication.

You will be issued with a certificate of inability to work based on your procedure, your professional activity and your requirements. It will normally cover between two and six weeks. In the case of major procedures and a physically demanding job, you may not be able to work for twelve weeks. Please ask your surgeon about this before your procedure and discuss it with your employer.

In most cases there will be a follow-up appointment six weeks after the procedure. Depending on the type of surgery, the investigation may include X-ray diagnostics. During the check-up, the doctor will tell you whether you need further check-ups.