Recovery from Back Surgery
By Nikki Clayton, PT, DPT, ATC
Back Pain that Requires Surgery
Over 70% of the US population experiences low back pain at some point in their life. In most cases, the patient recovers in 2-3 days; others recover with the use of physical therapy and medications. About 1% of those who suffer with back pain have a medical condition that requires surgery. Nevertheless, over 25,000 back surgeries occur each year. Although there are so many people who choose back surgery as an option, there is a wide range of satisfactory relief, 16-95%. With such a wide range of satisfaction, research has recently looked at comorbidities and recovery not as separate entities but as factors that show a level of correlation with each other.
Smoking and It’s Effect on Back Surgery
Perhaps the greatest influence on the success of back surgeries, spinal fusion, in particular, is smoking. Studies show that patients who smoke have advanced degenerative changes in the low back compared to non smokers, and are more likely to have disk herniation. Such conditions may be resolved via a spinal fusion. During a fusion, the doctor places small pieces of bone along the front or back of the spine to encourage the bones to grow together in order to fuse that section of the spine. With patients who smoke, the nicotine influences the amount of blood reaching the bone graft, therefore affecting healing. Over 54% of smokers require multiple back surgeries compared to less than 50% of non-smokers. This is a great example how of comorbidities and recovery can be detrimental one another.
What If I Stop Smoking Today?
Research suggests that those who quit smoking for longer than 6 months post operatively, not only have a significant improvement in healing following spinal fusions, but also are 40% more likely to return to full work duty compared to those who do not quit.
Other Comorbidities on Recovery From Back Surgery
There are multiple other factors that have an influence on the success of back surgeries including depression, anxiety, and family stress. Those with such psychological concerns tend to have low threshold for pain and focus on negative events. If you are a patient impacted by such psychological concerns, it is optimal to seek counseling prior to surgery and also to focus on small successes. Have your family reward good behavior and positive achievements in order to help you see the improvement toward your ultimate goal. Obesity is another factor to consider when having any type of back surgery. Surgical risks such as blood clots, UTIs, and failure of the hardware increase with obesity. It is important to understand these risks and to get moving early. Talk to your Physical Therapists about ways in which you can reduce your risk of complications through your home exercise program.
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