Lumbar Disectomy

In Hospital

This procedure is generally considered to be the most commonly performed and the least complex of the spinal operations. This means that, mostly, recovery from surgery is the least disruptive. Pain relief is enhanced by local anaesthetic and cortisone which is placed around the inflamed nerve at the time of surgery; however additional pain relievers are made available upon return to the ward. After the operation patients are encouraged to walk around their hospital room on the day of surgery. This is supervised by the ward physiotherapist who will also provide a gentle program which includes anti-blood clotting exercises. TED (ThromboEmbolic Deterrent) stockings will be in place and should be worn for 6 weeks after the operation in order to avoid blood clotting in the legs. Food and fluid may be taken as soon as desired. An IV drip will be in place overnight and will be generally removed the next day.

Most patients are sufficiently recovered to leave hospital on the day following surgery. There are exceptions, however, including where difficult home circumstances exist and where patients live in a rural community. Each situation is considered individually. A clear rubbery wound dressing is applied which will remain in place for 2 weeks. This dressing is water resistant and showers may be taken, however the wound should not be immersed (bath, swimming pool) for the first fortnight. It is safe to travel home as a front seat passenger with the seat near-fully reclined and wearing a seat belt. Driving should be avoided for 6 weeks after the surgery.

At Home

In the first few days following the surgery the back may be stiff and uncomfortable. This is quite usual and reflects the recent surgery. Leg pain of the type which was present before the operation may also be present however should not be as severe as it was previously. "Pins and needles" in the leg may also be experienced. This may result from either the previous pressure on the spinal nerve or from its manipulation during surgery and is quite common. Again, the leg pain should not be as severe as it was before the operation and in the vast majority of cases will subside prior to the 6 week postoperative consultation. The pain may be treated with simple "over the counter" pain relievers however, if persistent, Assoc. Professor Richard Williams' rooms should be contacted for further advice.

At 2 weeks following the day of surgery a visit to your local general practitioner should be arranged for removal of the wound dressing so that satisfactory healing may be confirmed. The sutures are under the skin and do not need removal.

Activity should recommence gradually. In the first 2 weeks, activity should be confined largely to the home and involve only personal hygiene and minor tasks involving no exertion. From 2 weeks (the time of wound dressing removal) to 4 weeks a gentle exercise program may be instituted. This will include activities such as gentle walks around the neighbourhood, swimming or use of an exercise bike. The exercise program provided by our physiotherapist will also be in place.

At 4 weeks after the operation, general household duties (without bending or lifting!) may be recommenced and the exercise program stepped up. In a non-manual occupation, work could recommence at 4 weeks. In a manual occupation 6 weeks away from work will be required. Wherever possible, recommencement at work for both manual and non-manual workers is most desirable in half days for the first week, after which full active duty may be undertaken.

The first postoperative visit with Assoc. Professor Richard Williams is usually at the 6 week mark (or just prior to recommencement at work). The appointment for the visit should be made well in advance - most patients call Dr.'s rooms prior to leaving the hospital to be sure of a convenient appointment time.

At any time in the postoperative course Assoc. Professor Richard Williams is available to answer questions or give advice regarding any difficulty which is being experienced.

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