In this video, El Paso Spine Center founder, Dr. Smith shares a concise explanation of what to expect following a minimally invasive lumbar spinal fusion. Although the emphasis here is on lumbar fusion, many of the points raised in this article are also applicable to other surgeries such as microdiscectomy and endoscopic discectomy.
Advantages of Minimally Invasive Surgery
Minimally invasive surgery is highly successful at minimizing post-operative pain and recovery time. These surgical procedures are typically conducted as outpatient procedures or, at most, with a single night’s stay in the hospital. You can usually return to normal activities in less than two weeks.
However, many patients ask, “When will I be 100 percent?” Especially for those who have experienced back pain for many months or even years, it’s natural to anticipate complete recovery. It’s important to remember that your body, especially the muscles of your lumbar spine, will need time to regain strength. You may even have put on a few pounds over the years, which can slow down your post-operative rehab.
While you may still feel weak 12 to 16 weeks following the surgery, remember that even a sprained ankle takes around 12 weeks to heal. Strengthening your core spinal muscles will require time, dedication, and perhaps a change in mindset. As your doctor, my role is to encourage and motivate you. The more you do, and the quicker you do it, the better you’ll feel, within reason. It may be several months until you can return to deadlifts, squats, or contact sports.
Your timeline to achieving one hundred percent recovery depends largely on the goals you set for yourself and how hard you work. Ultimately, this journey is about you. My goal as your doctor is to see you achieve the best result possible.
Postoperative Imaging Studies
You may wonder when we do imaging studies following spinal surgery. X-rays are conducted on the day of surgery. You will be seen back in the office two weeks after the surgical procedure to evaluate the incision. The first x-rays are done 10 weeks postoperatively.
If your job involves heavy lifting, assuming the x-rays look good, you can begin core strengthening exercises at 10 weeks postoperatively. X-rays may also be taken at any time if there’s trauma such as a fall.
There are important factors to consider when viewing x-rays and radiology reports following a lumbar fusion. For instance, the bone graft used for a lumbar fusion is initially very visible on x-rays, but as blood vessels grow into the bone, the graft becomes less visible. However, this is a normal process indicating that healing tissue and calcium, brought by the blood vessels, are resulting in a solid fusion.
CT Scans and MRIs
A CT scan, a special type of x-ray, has replaced normal x-rays in many emergency rooms. If you are involved in an unfortunate accident such as a motor vehicle accident, you are likely to be evaluated with a CT scan.
Under normal circumstances, postoperative MRIs are not typically required. However, any new neurologic deficit, infections, or x-rays that indicate failure of instrumentation may warrant an MRI scan. It’s important to note that postoperative tissues vary in their water content, and surgery can cause swelling, affecting the MRI’s image quality.
Therefore, the best MRI images occur after 12 to 16 weeks postoperatively when most of the swelling has resolved. It’s crucial to plan your MRIs to get the best images possible, as insurance constraints might limit the number of scans.
Advantages and Disadvantages of Minimally Invasive Spinal Surgery
Minimally invasive lumbar fusion boasts several advantages, including a smaller incision, minimal damage to normal tissue, protection of adjacent levels, less scar formation, reduced infection risk, and less risk of a spinal fluid leak. There are also numerous other advantages, such as less pain and quicker recovery.
One potential disadvantage of minimally invasive spinal surgery is that by damaging the least amount of tissue possible, there might be a risk of not removing enough tissue. However, if a second surgical procedure is needed to remove a piece of disc or other tissue, there’s no need to repeat the entire surgery. The screws are well-positioned and do not need to be removed or revised.
Although all reasonable precautions are taken to prevent any issues, it’s crucial to understand that there is no surgeon and there are no types of surgical procedures that carry a zero percent chance of complications.
If you have any questions or concerns, feel free to reach out to Dr. Smith at El Paso Spine Center.