1. Post Operative Care of the Spine Patient
Anthony Russo, MD
Montana Spinal Institute
Montana Orthopedics

2. OBJECTIVES
Identify surgical approaches and understand unique complications of each
Managing the chronic pain patient

3. Surgical Approaches
Cervical
Anterior
Posterior
Lumbar

4. Unique Complications:
Surgical Approaches
Anterior Cervical
Unique Complications:
Retropharyngeal
Hematoma
Epidural Hematoma

5. Surgical Approaches Anterior Cervical
Retropharyngeal Hematoma
Worsening Dysphagia
Voice Change
Anterior Neck Edema
Stidor
Wound Bleeding

6. Surgical Approaches Anterior Cervical
Epidural Hematoma
Worsening Neurologic function
Weakness
Hyperreflexia

7. Surgical Approaches Posterior Cervical
Wound Complication
Esp. with collar
Epidural Hematoma
Worsening Neurologic function
Weakness
Hyperreflexia

8. Surgical Approaches Lumbar - Anterior and Posterior
Epidural Hematoma
Wound Complications
Hardware Failure

9. General Complications
Cardiac
MI, arrhythmia
Respiratory
Atelectasis, pneumonia
Urinary
UTI, retention, incontinence - notify MD GI
N/V, Ileus
Endocrine
Diabetes

10. Pain Management Chronic Pain Patients Start with baseline pain regimen
Additional meds proportionately
Very sensitive to timely response

11. Spine Procedures Most Painful Posterior Lumbar Posterior Cervical
Anterior Lumbar
Anterior Cervical
Least Painful

12. Spine Pain Management Aggressive Medication Use
Opioids, Muscle relaxants; Anxiolytics
NO NSAIDS
Careful, Frequent assessment

13. Spine Pain Management Questions?

14. Spine Rehab All Patients Lumbar Patients Cervical Patients
No lifting > 15 lbs
No pulling with arms
Ambulate as soon as tolerated
Can shower as soon as drain out
Lumbar Patients
No excessive bending/twisting at waist
Cervical Patients
Collars for comfort use unless ordered otherwise

15. Spine Rehab Questions?

16. Thank you