What type of Exercise Should / Can I do after Spine Surgery?

What type of Exercise Should/Can I do after Spine Surgery?

After the decision has been made to proceed with spinal surgery, you will discuss preoperative preparation, the surgical procedure, and what activity level can be resumed postoperatively Exercise is always good for you (when done properly). Especially considering activities—strength training, aerobics, yoga and or walking—can all be good for you during and after recovery if done properly and under guidance of a trained physical therapist. A different regimen will be assigned depending on your specific surgery, for example, lumbar fusion, cervical fusion, lumbar decompression, laminectomy, stenosis surgery, herniated disc surgery, It is always advised to take it slow as your procedure is in the initial phases of the healing process. You will not be able to exercise at your normal level right away because you have to let your body heal properly.

There are several parts that have to heal before returning to normal excercise routines.  Generally, the first thing to heal is the incision. This takes between 7 and 14 days after an open procedure (when the incision is large). The skin healing process takes a bit less time after a microscopic or minimally invasive surgery (where you have several small incisions). You
cannot see the rest of the healing process, since it occurs under the skin.  Muscles and other tissue that was manipulated during surgery must have time to heal properly. Lastly, but most importantly, the bone must fuse in order to heal. This usually takes anywhere from 6 to 9 months, and Dr. Lattuga will be able to see if the bone has fused completely by using an X-ray or a CT scan.

Patients should take great care with your back as your body recovers from surgery: no heavy lifting, bending, or twisting. In other words, do not put excessive
strain on your back.

For the patient, that means that as you ease back into exercise (under Dr. Lattuga’s guidance), you’ll need to be extra cautious of any movements that will cause motion in the area of your back that is trying to heal and fuse. The purpose of a fusion is to allow this area to become solid, and stabilize your spine. Sudden movement, excessive movement or even one wrong –strained movement in this area will cause the fusion to fail and you want to avoid this at all costs.

For example, with outdoor laborers, contractors or union workers, work can involve twisting, flexion, and extension of your spine.  Dr. Lattuga can speak with you about specific duties
that may cause pain, unwanted motion of the spinal levels trying to fuse, or even fusion failure. You do not want to do anything to keep the fusion from healing properly, so work with your health care professional to figure out what’s best for you and your body—do not make these decisions on your own or go against your doctor’s advice when it comes to this.

As the fusion heals, you can generally go back to low-impact exercise.  Walking is a great low-impact exercise because it avoids unwanted motion to the spine and actually aides in bone fusion.  Swimming could also be a great exercise that might be appropriate for your post surgery exercise regimen.. Swimming can give you an amazing total body workout in a very safe (for your fusion) environment. The water will support your body weight, so your back will not be carrying as much weight as you work out. After the fusion heals and after you have received permission from Dr. Lattuga you should be able to resume your typical activities. You can still be a very active person after spinal fusion surgery – especially if you follow the proper routine during recovery!!!

Depending on your prior flexibility, you may need to adjust your expectations. You’ll still be exercising and doing a great job of taking care of your body.

Dr. Lattuga wishes you the best in your spinal fusion surgery and recovery!

Tags: cervical fusion post op recovery, dr. lattuga, excercise after spine surgery, excercise post fusion, lumbar fusion, sebastian lattuga

What to Know Before Spine Surgery

What to Know Before Spine Surgery

Stupid Questions Do Not Exist Before Surgery!

If a patient is going to have treatment for spinal stenosis they might have a few questions in their mind before going to visit their surgeon.  Some patients have stated they even feel overwhelmed. want to make sure that all of our patients at New York Spinal Associates think about questions/concerns before coming to the office so Dr. Lattuga can manage patients questions and expectations as early in the
process as possible.

No question is a stupid question when you’re preparing for spine surgery. You have a right to know everything that’s going to happen before, during, and after the surgery, and you also have a right to have all the risks and benefits fully explained to you. To help you make an informed decision , it is in the patients best interest to educate themselves.

Dr. Lattuga knows that, “no question is stupid,” and that you have a right to all that surgery information doesn’t make asking the questions any easier. Surgeons, by no fault of their own, can appear intimidating; however, they are also be very interested in patient education and feedback. Dr. Lattuga wants his patients to understand what’s happening so that you can feel confident in your decision and be as relaxed as possible on your day of surgery.

Dr. Lattuga knows: the better you understand the procedure, the easier it will be for him to give you the proper treatment and guide you with appropriate recovery methods after undergoing surgery for spinal stenosis.  You know, surgery is like any other major decision in your life, and before you buy a house or take a vacation, you probably do your research and try to understand everything you can—even if that
means asking some basic questions.

Some questions Doctor Lattuga recommends being prepared to ask before a spinal stenosis procedure or any other spinal surgery are:

What kind of surgery are you recommending for me? 

Why are you recommending this specific surgery?

Are other surgeries used to correct my condition? Why aren’t those being recommended to me?

How much experience do you have with this procedure?

What are the risks associated with this procedure? What is the percentage of complications with this surgery?

What could happen to me if I do not  have spinal surgery?

How long will the surgery be?

How long will I need to be in the hospital after the surgery?

Will there be a lot of pain after the surgery as I recover? What’s your plan for dealing with the pain?

What should my expectation for recovery be? How would you define recovery in my case?

What are possible complications during the recovery period? What are signs of those complications, and at what point should I call you?

A patient’s particular concern may be different before surgery but they need to make sure to ask all the questions necessary before the spine surgery is underway.   If it will make you feel more comfortable, you
can have all the questions written down ahead of time.  The organization of writing them down will help you cover all the questions and make sure you have peace of mind before the surgery is underway.  When you ask
all the questions you need, you’ll feel more prepared for your surgery.  Dr. Lattuga and his staff (both front office and back office) are fluent in Spanish so please do not let a language barrier stop you from asking these questions.  Dr. Lattuga’s office is more than happy to make sure our Spanish speaking clients have all questions answered appropriately before their spine surgery.

Tags: dr. lattuga, questions before surgery, sebastian lattuga, spine surgery, spine surgery questions, spine surgery recovery

Disc vs. Dehydration: Don’t Risk It

Disc vs. Dehydration: Don’t Risk It

Upwards of 70% of your body is composed of water (H2O). Some studies say as little as a 2% decrease in fluid level can leave you itchy, lethargic, constipated, and feeling poor all around. It certainly makes sense to stay hydrated; it can even prevent headaches and joint aches. 

You might be asking yourself, “What does this have to do with my spine?” Quite a bit actually, not only is over 70% of your body made up of water, but a similar ratio exists in the discs that cushion the vertebrae in your spine. Dehydration is not often talked about (outside of the medical world) as a contributing factor in cases of herniated or bulging discs.  A decrease in disc water content is associated with spinal disc degeneration. As discs break down, cracks form in the fibrous outer ring of the disc leading to fluid loss. The inner core becomes weaker as it shrinks and comes under more stress until conditions increase chances for disc to bulge or become herniated causing leg pain and weakness.

In addition, as dehydration can cause joint aches, we must remember that our spine is composed of multiple joints (facet joints) that run along the left and right side of each vertebral body.  The same way your knee joint can exhibit pain, so can the joints of your spine.

This is one of the most common causes of pinched nerves or slipped discs.  Radiating leg pain may be a sign of bulging spinal disc that irritating the nerve root.  Although most of the patients who develop a herniated disc and the resultant sciatica can heal without surgery, it is often a popular choice to speed up the process.  If surgery is chosen as a solution for spinal disc injuries, a  removal of the portion of herniated disc material is the usual procedure.

 Medical Professionals recommend 8 to 10 8oz glasses of water daily.  Dr. Lattuga suggests 12 to 16 8oz glasses, equivalent to 1 gallon of water.  Dr. Lattuga would also recommend distilled water for its great cleansing qualities. The consumption of 1 gallon of water a day is a necessity for anyone working outdoors, especially in the summer months, (i.e.,  members of labor unions: MTA, Steel Workers Union, Teamsters, Carpenters Union, Iron Workers, Contractors, Athletes, Postal Workers). Not only are they prone to dehydration but their jobs are often entailing heavy lifting.  Exactly how much water is enough can be a matter of significant debate. The most commonly given “rule” is to drink at least eight 8-ounce glasses of water a day. The amount your body really needs largely depends on your gender (males tend to require more water), weight (larger mass requires more water), activity level, and environment among other factors. Normally, if you’re drinking enough water your urine will be clear or pale yellow; if it’s not, drink a glass of water, and be aware of how much you are consuming throughout the day. Often times, many people forget to hydrate, or do not hydrate themselves enough throughout the day.

  The disc space (intervertabal disc) is water soluble. As we age, the percentage of water we have in our bodies decreases, simultaneously our intervertebral discs decrease in water content leading to disk collapse and joint space narrowing.   Aging increases the process of natural degeneration of the spine which narrows the space through which nerves exit the spine (foramen). This may cause pressure on  the nerve canal.  The physical aspect of a job with manual labor involved, the chance of dehydration only increases the risk of damage to your discs. When your body is properly hydrated, you spinal discs are able to reabsorb fluids at night while you sleep, aiding in easier bodily movements such as flexion, extension and rotation.

In conclusion, proper hydration is paramount to overall body health and more specifically to your spine’s health.  Patient’s that are physically active for either leisure or work commitment should be extremely aware of staying hydrated especially in extreme weather conditions.

 So yes, water will help your spine stay healthy too.

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What can I do About Neck Pain Caused By Whiplash?

What can I do About Neck Pain Caused By Whiplash?

Whiplash is cervical spine strain caused when the head and neck are thrust quickly forward and backward.  The most common place for whiplash to occur is in a car accident but it can occur in other circumstances.  To understand how whiplash can cause neck pain, you need to recognize the head, which weighs approximately 8-13 pounds is supported and moved by the neck. Due to the weight of your head it easy for soft neck muscles and ligaments to be stretched.  Whiplash can occur even during a mild accident.

The seriousness of a whiplash injury depends on the force / speed of the impact, the way the injured was seated in the car, and if he / she was properly restrained using a shoulder harness seat belt.  The injury will usually be more severe if your head was turned at the time of impact, not wearing a seat belt with shoulder belt, or your headrest was not at the proper height.  It is important to remember that the car doesn’t have to be in a severe collision for whiplash to occur.  Always see a doctor when a chance of whiplash arises.

Home treatment tips for whiplash: Ice and Heat

Home treatment tips for whiplash can include a combination of ice and heat.  Ice helps to reduce swollen overstretched muscles and ligaments while heat increases circulation and eases tight stiff muscles.  Ice and heat can be alternated on the affected area, 15 minutes on and 15 minutes off.  Never sleep with an ice or heat pack.

Over the counter anti-inflammatory medication may be recommended.  These medications may include: acetaminophen (Tylenol), ibuprofen (Advil), Naproxen (Aleve).  Please speak to your physician prior to starting these medications.

After whiplash injury activity restrictions should include taking slow, deliberate and gentle movements to prevent further stiffness after whiplash injury.  If you work at a computer, taking frequent breaks to relax neck muscles is recommended.
Avoid carrying heavy packages, especially things such as a pocket book or backpack’s slung over one shoulder.  Avoid cradling your cell phone (or regular phone) with the head and
shoulder.

Neck pain is common either immediately following or several days after a whiplash accident.  Fortunately, most symptoms go away in 2 – 4 weeks.  If your symptoms worsen, or you
develop a headache, dizziness, blurred vision, difficulty swallowing, arm or hand numbness contact Dr Lattuga immediately for an appointment at 516-355-0111

Tags: car accident, dr sebastian lattuga, neck pain, neck surgery, new york spinal specialists, sebastian lattuga, spine surgery, whiplash, whiplash symptoms, whiplash treatment

Have Your Bones Healed Properly after Surgery? FAILED FUSION

Pseudoathrosis — Failed Fusion

Have Your Bones Healed Properly after Surgery?

One question Dr. Lattuga hears from patients that are going to be having a lumbar or cervical fusion is:  How can I know if I have my bones have healed properly.

In general, it takes six to nine months for your bones to fuse properly after a spinal fusion surgery. Over that period your medical team should keep you on a series of restrictions: Examples; no heavy lifting, bending, twisting, or overly strenious activity.  Your bones are working hard to fuse themselves back together (and to the instrumentation) after a lumbar or cervical fusion procedure.  It is critical not to exert too much stress on your back until you have received proper clearance from your surgeon.

Dr. Lattuga will be checking on your progress during the months following your spine surgery.  In having your spinal fusion with New York Spinal Specialists, you will have several follow up appointments so we can check on your progress. During those appointments Dr. Lattuga will, most likely order X-rays.  X-rays are the most useful imaging tests to check on how your bones are healing and fusing after a lumbar fusion or cervical fusion, because they show accurate images of your bones.

In those X-rays, our team at New York Spinal Specialists are looking for evidence of a successful fusion. In rare instances bones may not fuse properly. One of the signs for pseudoarthrosis (failed fusion) is a halo formation on the X-ray. This appears around a screw used in the surgery to stabilize your spine until the bones fuse and area able to provide support and stability.  If the fusion doesn’t happen as it should (pseudoarthrosis), the screws can loosen. These loose screws will show up with a ring around them—a halo formation—on the X-ray.

In order for our patients to show good improvement during that very vital first year after surgery, we place them under strict orders to give patients the greatest likely hood of a proper fusion.  In successful surgeries, you should show improvement in pain and function (what you’re able to do); it may be slow at first, but as your bones heal and your body re-adjusts, you should notice a marked difference, especially when compared to your life and pain level before surgery.  For this reason, after your spinal fusion it is critical to make all scheduled follow ups.

If you have any questions regarding cervical fusion and or lumbar fusion procedures please feel free to call Dr. Lattuga’s office at 516-355-0111.  For online appointments click here

Tags: cervical fusion, dr sebastian lattuga, failed fusion, lumbar fusion, sebastian lattuga, spine surgery

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