Lumbar disc herniation is a common and frequently-occurring disease in spinal surgery. It is a manifestation of low back pain and low back pain caused by lumbar disc degeneration, fibrous annulus rupture, nucleus pulposus, stimulation and compression of nerve roots and cauda equina Syndrome. Most patients can be relieved by conservative treatments such as traction and strengthening psoas muscle exercises, but about 15% of patients will eventually need surgery.
Since Harvard University Medical School first used surgery to cure lumbar disc herniation in 1934, the history of surgical treatment of lumbar disc herniation has reached more than 80 years, and the surgical methods have been continuously updated, such as minimally invasive percutaneous intervertebral endoscopy, lumbar spine Posterior decompression, interbody fusion, artificial lumbar disc replacement, etc. The technology is gradually improved and the treatment is more precise, but there will still be complications such as poor healing of the incision, infection, and nerve damage after the operation, which seriously affects the patient’s rehabilitation effect. Therefore, postoperative care should not be ignored, and patients should pay more attention to exercise the back muscles, so as to reduce complications, accelerate recovery, and avoid recurrence. Specifically, it should be done——
1. Strict bed rest
After the operation, the patient needs to stay in bed strictly. The bed is best to use a hard bed. The bed time depends on the patient’s age, physique and operation method, whether the scope of the resection tissue is bone grafted, whether internal fixation, etc., the short is three to five days, the long is several Months. In the early stage of bed rest, medical staff or family members are required to give an axis turn every 2 hours, that is, the head, neck, shoulders and waist and legs are kept in a line and turned in the same direction, without twisting, to prevent re-injury of the lumbar spine and joints Dislocation ensures good healing of the lumbar fascia, muscles, and ligaments, and avoids the formation of pressure sores. During bed rest, the patient can do some exercises of lying on his back and pedaling to avoid nerve root adhesion and strengthen the strength of the lower back. After full bed rest, the patient can get out of bed and move around under the protection of waist assist devices. But before getting out of bed, wear a waistline on your back, then lie on your side, sit up with the help of others, and then slowly land and walk around. If there is bone graft during the operation, it is advisable to use a plaster vest to fix it for 3 to 4 months. After the bone graft is fully healed, go down to the ground.
After the operation, mental workers can gradually return to work after 2 to 3 months, and manual workers can only start working after 3 to 4 months. Work should be from light to heavy, working hours from short to long, and avoid strong bending or weight-bearing activities. In daily life, avoid bad postures such as bending over and arching back, and avoid strenuous sports. For young women who have not given birth, they should fully recover for a period of time after surgery (such as 1 year after surgery) before considering pregnancy and childbirth, otherwise it will easily lead to recurrence or even aggravation of preoperative symptoms.
2. Diet “three lows and three highs”
The postoperative diet is based on the principles of low fat, low cholesterol, low salt, high protein, rich vitamins and dietary fiber. Protein is an essential nutrient for the formation of muscles and ligaments, as well as a nutrient required for bones; vitamins B, C, and E can nourish nerves and relieve pain; dietary fiber can prevent and treat constipation. The food to choose from is milk, eggs, animal liver, soy products, kelp, and fresh fruits and vegetables. Try to diversify your diet.
3. Insist on low back muscle exercise
Starting from the removal of the drainage tube, the patient should gradually strengthen the muscles of the lower back and back, and persist after returning to daily activities. Commonly used methods are five-point, three-point and flying swallow.
Five-point Pose: Take the supine position, with the headrest, elbows, and feet as fulcrums, push up your chest and abdomen, and try to keep your back away from the bed.
Three-point Pose: Take the supine position, with the headrest and feet as the fulcrum, push up the chest and abdomen, and try to keep the back of the bed away from the bed.
Flying Swallow Pose: Take the prone position, bring your lower limbs together, place your hands apart on your side, straighten and raise your head at the same time, raise your hands back, the abdomen is the support point, and look like a flying swallow.
4. Reasonable use of assistive devices
Under the guidance of a doctor, choose assistive devices to help recover. When the patient wears the protective gear, he must first lie on his side, place the back of the protective gear on his back, and then lie on his back. Place the front part of the protective gear on the chest and abdomen, fasten the middle tie, and then buckle the two sides. Wearing protective gear can ensure that the part of the intervertebral disc is fully rested and avoid re-injury. When the condition is relieved, it is necessary to remove the waist circumference in time and promote recovery through self-exercise.
5. Regular review
Regular outpatient review at 1 month, 3 months, 6 months, and 12 months after surgery. If there is no problem after 1 year, the follow-up review will be once a year, and then it can be extended to once every 3 years. The content of the review is mainly to take X-rays to see the healing of the operation department and the condition of the internal fixation.