Problems with Anesthesia Problems can arise when the anesthesia given during surgery causes a reaction with other drugs the patient is taking. In rare cases, a patient may have problems with the anesthesia itself. Be sure to discuss the risks and your concerns with your anesthesiologist. Thrombophlebitis Blood Clots Thrombophlebitis, sometimes called deep venous thrombosis DVT , can occur after any operation.
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Problems with Anesthesia Problems can arise when the anesthesia given during surgery causes a reaction with other drugs the patient is taking. In rare cases, a patient may have problems with the anesthesia itself. Be sure to discuss the risks and your concerns with your anesthesiologist.
Thrombophlebitis Blood Clots Thrombophlebitis, sometimes called deep venous thrombosis DVT , can occur after any operation. It occurs when the blood in the large veins of the leg forms blood clots. This may cause the leg to swell and become warm to the touch and painful. If the blood clots in the veins break apart, they can travel to the lung, where they lodge in the capillaries and cut off the blood supply to a portion of the lung.
This is called a pulmonary embolism. Pulmonary means lung, and embolism refers to a fragment of something traveling through the vascular system. Most surgeons take preventing DVT very seriously. There are many ways to reduce the risk of DVT, but probably the most effective is getting you moving as soon as possible. Two other commonly used preventative measures include pressure stockings to keep the blood in the legs moving medications that thin the blood and prevent blood clots from forming Infection Infection following spine surgery is rare but can be a very serious complication.
Some infections may show up early, even before you leave the hospital. Deeper infections that spread into the bones and soft tissues of the spine are harder to treat and may require additional surgery to treat the infected portion of the spine.
Nerve Damage Any surgery that is done near the spinal canal can potentially cause injury to the spinal cord or spinal nerves. Injury can occur from bumping or cutting the nerve tissue with a surgical instrument, from swelling around the nerve, or from the formation of scar tissue. An injury to these structures can cause muscle weakness and a loss of sensation to the areas supplied by the nerve.
The nerve to the voice box is sometimes injured during surgery on the front of the neck. Surgeons usually prefer to do surgery on the left side of the neck where the path of the nerve is more predictable than on the right side. During surgery, the nerve may be stretched too far when retractors are used to hold the muscles and soft tissues apart.
When this happens, patients may be hoarse for a few days or weeks after surgery. In rare cases in which the nerve is actually cut, patients may end up with ongoing minor problems of hoarseness, voice fatigue, or difficulty making high tones.
Problems with the Graft Fusion surgery requires bone to be grafted into the spinal column. The graft is commonly taken from the top rim of the pelvis. There is a risk of having pain, infection, or weakness in the area where the graft is taken. After the graft is placed, the surgeon checks the position of the graft before completing the surgery. However, the graft may shift slightly soon after surgery to the point it is no longer able to hold the spine stable.
When the graft migrates out of position, it can cause injury to the nearby tissues. A second surgery may be needed to align the graft and to apply metal plates and screws to hold it firmly in place. Nonunion Sometimes the bones do not fuse as planned. This is called a nonunion, or pseudarthrosis. The term pseudarthrosis means false joint.
If the joint motion from a nonunion continues to cause pain, you may need a second operation. In the second procedure, the surgeon usually adds more bone graft.
Metal plates and screws may also be added to rigidly secure the bones so they will fuse together. Not all patients get complete pain relief with this procedure. As with any surgery, you should expect some pain afterward. If the pain continues or becomes unbearable, talk to your surgeon about treatments that can help control your pain. After Surgery What happens after surgery? After ACDF, patients usually wear a special neck brace for several months.
These neck braces are often bulky and restrictive. However, the bone graft needs time to heal in order for the fusion to succeed. This requires the neck to be held still. Recently, surgeons have begun using metal hardware, called instrumentation , to lock the bones in place. This hardware includes metal plates and screws that are fastened to the neck bones.
They hold the neck bones still so the graft can heal, replacing the need for a rigid neck brace. Patients may stay in the hospital for one to two days after surgery. When the surgery is done on an outpatient basis, patients may even go home the same day of surgery. Patients can get out of bed as soon as they feel up to it. They usually drink liquids at first, and if they are not having problems, they can start eating solid food.
Patients are able to return home when their medical condition is stable. However, they are usually required to keep their activities to a minimum in order to give the graft time to heal.
Rehabilitation What should I expect as I recover? Rehabilitation after ACDF can be a slow process. You will probably need to attend therapy sessions for two to three months, and you should expect full recovery to take up to eight months.
Many surgeons prescribe outpatient physical therapy beginning a minimum of four weeks after surgery. At first, treatments are used to help control pain and inflammation. Ice and electrical stimulation treatments are commonly used to help with these goals.
Your therapist may also use massage and other hands-on treatments to ease muscle spasm and pain. Active treatments are slowly added. These include exercises for improving heart and lung function. Walking and stationary cycling are ideal cardiovascular exercises. Therapists also teach specific exercises to help tone and control the muscles that stabilize the neck and upper back. Your therapist also works with you on how to move and do activities.
This form of treatment, called body mechanics, is used to help you develop new movement habits. This training helps you keep your neck in safe positions as you go about your work and daily activities. At first, this may be as simple as helping you learn how to move safely and easily in and out of bed, how to get dressed and undressed, and how to do some of your routine activities. As your condition improves, your therapist will begin tailoring your program to help prepare you to go back to work.
Some patients are not able to go back to a previous job that requires heavy and strenuous tasks. Your therapist may suggest changes in job tasks that enable you to go back to your previous job or to do alternate forms of work. Before your therapy sessions end, your therapist will teach you ways to avoid future problems.
ACDF REHAB PROTOCOL PDF
Zulujora Physiopedia articles are best used to find the original sources of information see the references list at the bottom of the article. Most common cause for this operation is a ruptured cervical intervertebral disk. To prevent the vertebrae from collapsing and rubbing together, a spacer bone graft is inserted to fill the open disc space. Therefore protocols are used.