Who Needs It?
This operation is performed for the condition known as lumbar canal stenosis, when the spine is too narrow for the nerves contained within. Patients typically complain of impaired walking distance and leg pain on exertion. The spinal narrowing is caused by arthritic changes in the joints in the spine which then enlarge. This encroaches on the space available for the nerve roots and leads to the symptoms of claudication.
Pre operative advice
48 hours before surgery, take some gentle laxatives (colace, senna) to ensure you have your bowels opened on the day of surgery.
On the day of your surgery it is important to remain Nil By Mouth (NPO). Please do not eat anything past midnight, but may continue to drink water up to two hours before admission, where you will be advised further.
It is not necessary to bring your medications with you, as these are supplied from Pharmacy at the hospital (you can use your medications when you return home). However, if you take a number of medications, please bring a list of names and doses so they can be appropriately supplied by the pharmacy department.
Please bring your scans with you to The Hospital.
How is it done?
This can be performed under general or epidural anaesthetic. The bone at the back of the spine is removed to enlarge the space available for the nerves. At the same time, if necessary, the foramina, the holes through which the nerves leave the spine, can be enlarged.
Post operative care
You will wake up in recovery, where you will spend a short time recovering from the anaesthetic.
You will then be transferred back to the ward. The contact numbers and visiting times are listed below.
You can eat and drink soon after your operation, when you feel comfortable. However, it is important not to eat or drink too quickly post operatively to avoid sickness and further complications. You will have maintenance fluids intravenously to keep you hydrated.
Post operatively, you will be seen by the physical therapy team on the ward. They will start teaching you how to safely get out of bed, and will help you to start walking again. You may feel lightheaded or dizzy the first few times you get up — this is normal, and will wear off. There are no specific restrictions after surgery, but lifting and bending should be avoided for the first few weeks.
The Nursing staff on the ward will have given you some information on wound care prior to discharge. If you have any concerns regarding you wound, please do not hesitate to contact us. The stitches are dissolvable and will not need removing. In general, all dressings can be changed after 72 hours, with a new dressing applied every day thereafter if the incision is draining. However, if no drainage is present, the dressing may be discontinued. Moreover, you may shower and wet the incision after 72 hours, but bathing or soaking the incision is not recommended for 2 weeks.
You are likely to need pain killers during your stay and for a short while at home. Pain killers can be constipating so we encourage you to eat food that will help to keep your bowels working well. Drink plenty of water.
Brace with Chairback lumbar support
After your operation you will need to wear a brace to support your muscles and spine (Similar to wearing a cast on your arm after surgery). It should be worn when you are out of the house, walking, shopping, when you are sitting in the car, bus, train or tube. You don’t need to wear it in bed or when you are sitting at home.
You may need to wear this for several weeks. You will be fitted with the appropriate size by the physiotherapist on the ward, and then be taught how to put it on correctly.
- The brace should be worn over the top of a vest, or light t-shirt to prevent skin abrasions.
- Don’t wear any greasy or oily lotions, or talcum powder, and fully dry the skin before applying the brace.
- The brace may leave some small red marks on the skin. These should disappear within 30 minutes of removing the brace. This is normal, the skin will gradually build up resistance to the brace. If it does not disappear after 30 minutes, contact the clinic as below.
- Clean your brace regularly with a damp cloth and soapy water. Wipe and dry thoroughly before re-applying.