Purpose of the surgery:
To perform decompression or internal fixation surgery through the back area to relieve nerve compression symptoms caused by lumbar disc herniation, lumbar spine stenosis, or lumbar tumors in order to preserve nerve functions.

Pre-operative preparations:

  1. The surgeon will arrange various examinations depending on the patient's neurological symptoms, such as lumbar X-ray photography, Computed Tomography (CT), Electromyography (EMG) , or Magnetic Resonance Imaging (MRI), in order to determine the location of the lesion.
  2. The surgeon will explain the purpose, process, possible risks, and complications of the surgery to the patient and family members based on the results of the pre-operative evaluations. Informed consent forms will be filled out afterwards. 
  3. Routine examination items include electrocardiogram, chest X-ray, and blood tests.
  4. Before the surgery, the nursing staff will arrange the patient to watch a lumbar spine surgery nursing guidance video and confirm the correctness of the patient's posture while getting in and out of bed.
  5. An appropriate waist or back brace will be prepared according to the surgeon's advice, so that it can be used when the patient gets out of bed after the surgery.
  6. After 12 o’clock midnight at the night before the surgery, the patient is prohibited from eating, drinking, and taking any oral medications.
  7. The patient should wear the surgical gown on the day of the surgery. Glasses (including contact lenses), movable dentures, nail polish, body accessories, amulet, and underwear should be removed.
Post-operative care:
  1. For the needs of the condition, the patient will have a wound drainage tube, drip, and urinary catheter after the surgery. Such devices will be removed after the patient’s condition is stabilized according to the surgeon’s advice. The patient should not pull out the tubes by himself/herself, which may lead to unwanted  injury.
  2. After returning to the ward after the surgery, the patient should try to drink a small amount of water according to the time indicated by the medical/nursing personnel. If the patient does not experience any discomfort, then the patient can begin to eat normally.
  3. For post-operative wound pain, the surgeon will administer painkillers to relieve the pain.
  4. After returning to the ward after the surgery, the nursing personnel will assist the patient to turn over every 2 hours, adjust to a comfortable lying position, and apply ice around the wound for 15 minutes as ordered by the surgeon to relieve the pain.
  5. On Day 1 after the surgery, the medical/nursing personnel will assist the patient in getting out of bed. When walking, a patient must wear a back brace or waist brace according to the surgeon's instructions.
Home care after discharge:
  1. The surgical wound should be kept clean and dry. Do not scratch or pick the wound. If there are symptoms of redness, swelling, heat, pain, or secretions in the wound, then the patient should return to the clinic immediately for follow-up analysis.
  2. The stitches will be removed about 7~10 days after the surgery, but patients with diabetes need to have the stitches removed according to the level of wound healing. After the stitches are removed, the patient can purchase adhesive skin closure tape and stick it on the wound to help the wound heal more naturally.
  3. The patient should wear the soft or firm back brace correctly for about 2 to 3 months and then receive a follow-up X-ray. The surgeon will determine the time to take off the back or waist brace according to the follow-up results.
  4. Avoid falling or doing vigorous activities.
  5. Implement daily healthcare.
  6. Return to the outpatient clinic regularly as recommended by the surgeon.
  7. Limitations for the range of activities
    1. Week 1: Have sufficient sleep and rest. The patient can take short walks and take rides in a car, but cannot drive. Avoid weightlifting and climbing stairs.
    2. Week 2: The amount of activity can be increased, but the patient should not get tired and should still have sufficient sleep.
    3. Weeks 3~4: The patient can do light work but repeated bending, lifting, rotating, and other actions that will cause back pressure are absolutely prohibited.
    4. Week 8: The patient can engage in normal activities, but still must avoid repeated bending movements or excessive rotation. Lifting weights should not exceed 20 kg, and arm lifting weights should not exceed 10 kg.
    5. Week 12: The patient can resume the previous workload, but still need to pay attention to avoid heavy work such as lifting heavy objects from a high place.
  1. Angelini, E,. Baranto, A., Brisby, H., & Wijk, H. (2020). Healthcare practitioners’ experiences of postoperative pain management in lumbar spine surgery care—A qualitative study. Journal of Clinical Nursing, 29, 1662–1672. https://doi.org/10.1111/jocn.15230
  2. Debono, B., Wainwright, T. W., Wang, M. Y., Sigmundsson, F. G., Yang, M., Smid-Nanninga, H., Bonnal, A., Le Huec, J. C., Fawcett, W. J., Ljungqvist, O., Lonjon, G., & de Boer, H. D. (2021). Consensus statement for perioperative care in lumbar spinal fusion: Enhanced recovery after surgery (ERAS®) Society recommendations. The Spine Journal: Official Journal of the North American Spine Society, S1529-9430(21)00002-4. https://doi.org/10.1016/j.spinee.2021.01.001
  3. Greenwood, J., McGregor, A., Jones, F., & Hurley, M. (2019). Rehabilitation following lumbar fusion surgery (REFS) a randomized controlled feasibility study. European Spine Journal, 28(4), 735–744. https://doi.org/10.1007/s00586-019-05913-6
  4. Guo, x., Hou, X., Ding, S., & Chang, S. M. (2019). Rehabilitation nursing for patient rehabilitation after minimally invasive spine surgery. International Journal of Clinical and Experimental Medicine, 12(3), 2450-2455. https://doi.org/ijcem.com/files/ijcem0085631.pdf
  5. Huang, Y. C. (2019)‧ Changes in Pain Characteristics and Activities of Daily Living after Lumbar Spinal Surgery for Degenerative Spinal Disorder Patients‧, Master’s thesis, College of Medicine, National Taiwan University, 1-83. https://doi.org/10.6342/NTU201903271
  6. Tong, Y., Fernandez, L., Bendo, J. A., & Spivak, J. M. (2020). Enhanced recovery after surgery trends in adult spine surgery: A systematic review. International Journal of Spine Surgery, 14(4), 623–640. https://doi.org/10.14444/7083
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