FAQ

You should let me know if you have a fall. We will need to make sure that the impact has not upset anything. The good news is usually everything is ok, other than you might feel a little more sore as a result. 

Nothing takes your brain’s trust in your spine away more quickly than pain and an operation. You need to get this trust back. A lot of this phenomena happens at the subconscious level, but you still feel it in your mind. You’ll feel hesitant and unsure of how strong or mobile your spine is.  

If you don’t get this confidence back you will end up with a downward spiral of muscle tightness and spasm. The best way to short circuit this muscle problem is to remain active after surgery. Remaining active is the best way to get your confidence back so you can get back to normal.

So recovery after surgery is a balance of remaining active, but not so much so that it damages anything from surgery. The exact advice will depend on what type of operation is performed and.

I will go through this with you in detail at the time.

In spine surgery, pain is always the symptom that improves the quickest, and numbness and weakness always takes the longest to improve. 

If you have numbness or weakness (or both) before surgery, then it is very common for these symptoms to persist after surgery. All surgery does is take the pressure off the nerves and allow them to recover. The nerve itself cannot be repaired during surgery, it has to do that itself, naturally. Sometimes patients notice that the numbness and weakness improves quickly, even the day after, but this is not guaranteed.

However it is very common for the pain to improve immediately. Most patients wake up from surgery and tell straight away that their nerve pain is almost, or completely gone.

Weakness (like numbness) is due to injury to the spinal nerves. When artritis compresses the nerve it causes injury to the nerve itself and this prevents the signals within the nerve passing through normally. These block signals mean that you feel numbness and weakness. Surgery will take the pressure of the nerve, but the injury inside the nerve itself has to be repaired on its own. The first step is to take the pressure off, and once this has been achieved then it is a matter of time for the nerve to repair.

How much it repairs itself depends on two things: time and severity. The longer you have had weakness and numbness, the less likely it will fully recover, and the more severe the weakness and numbness prior to surgery the less likely it will fully recover.

While nerve pain usually improves really quickly after surgery, weakness will take much longer, usually weeks to months. 

It is normal to have pain at the incision site for several days. You will also notice some pulling and stretching type muscle pain when you move around in the first 1-2 weeks. This is all normal and is due to surgery itself while the skin and muscles heal themselves. The good news is this will soon return back to normal and you’ll have no pain at the surgery site. 

Part of the service I offer is regular followup to monitor how you are going. The whole point of surgery is to improve your quality of life, and I stay with you during this process to ensure you reach that goal. So if you have pain at any point from surgery that you are worried about then contact my team here.

This depends on the type of surgery that you have had. I will go through this with you in detail at the time. Generally my philosophy is to get you back to normal as quickly as possible. No one in modern life has time to sit around for weeks on end recovering. Keyhole surgery has made it possible to get active and recover quickly. My whole surgical career has been built around the ethos of keyhole surgery for this reason. 

Physiotherapy has a very important role in the recovery process for some people. Surprisingly, not everyone needs physiotherapy after keyhole surgery. Often it is enough to just keep active by doing normal activities around the house or outside. I will go through this in detail with you at the time. 

The incision needs 2 weeks to heal properly, and cant be rubbed or irritated during this time. After this though it is perfectly fine to have a massage. 

Bruising is very normal. Sometimes it can look like I have dropped you on the floor or something similar! Don’t worry, that won’t have happened, but the bruise can be bigger than the size of the incision sometimes. The bruise does not suggest lots of trauma to the tissues. Instead what happens is a small amount of blood trickled up from the depths of the surgery site and settles under the skin layer. It then moves southward under the influence of gravity. Then as the blood breaks down it turns into blue and yellow colours which are visible through the skin. It is quite normal and will quickly disappear over a couple of weeks. The bruise itself is not tender, it just can look impressive. 

Yes you can. If any metal is put into your spine (I like to think of this as spinal bling!) It won’t be a problem because these days it is all made out of titanium, the same stuff they use in race cars. It is a magical metal that is very strong, very light and completely non magnetic. Therefore the big magnets used in MRI scanners and the detectors used at airports won’t be a problem. 

The good news is, if you have metal in your spine from surgery, this will not set off the alarms at the airport. The reason is the metal is made of titanium, which is non magnetic. So you won’t have to carry your x-rays around to show the guards! 

Despite modern technology (including computer-guided navigation, robotics, instrumentation and modern imaging) and modern techniques (the latest in keyhole surgery), surgery does not come with a 100% guarantee.

Having said that, there are many operations that I can do where I am 90-95% sure that you are going to do very well.

I can also safely say that the risk of the surgery is very low. This is calculated by looking at the hundreds of cases I have personally done and calculating the number of complications I have had over this time. For the serious complications, this calculates at less than 1% which is much better than the average. Unfortunately, not all surgeons keep track of their results and instead just quote an average number without really knowing what their own true number is.

The advantage of keeping track of my own results is I can tell if there is an area I need to improve further, or if there is an area I can be proud of. Because of this process of constant learning, I can now be very proud of the high level of surgical technique for every operation I perform.

Despite these positives, however, you may still not achieve the goal of surgery that we set. For almost all patients the goal of surgery is to improve your quality of life, and get back to normal life as soon as possible. There are many things that can influence this. There are several factors that give a clue as to how well you will go, including our history, my examination findings and your scan. During the time I see and examine you and your scans, I will be looking for these factors so I can give you the best prediction of how you will be after keyhole surgery. It is my objective to give you as accurate a prediction as possible and then try to achieve that or do better. For example, in many cases, I predicate a 90-95% chance of being pain-free and returning to normal. In other cases, I may calculate that you have a 60% chance of being better, a 35% chance of being the same and a 5% chance of being slightly worse. In this situation, I would go through all the details with you clearly and together we would make a decision about what we are going to do with those odds based on how bad your quality of life is.

When I see you I will give you the most accurate prediction I can so you can make an informed decision.

There is no role for hopeful predictions or falsely positive predictions. Your health is your most valuable asset and to that end I will treat it as such. This starts with a brutally honest and scientific discussion.

The best way to think of this is ‘if you are worried, then I am worried.’ So if you have had surgery and now you have new symptoms then contact my team here immediately and I will be very happy to see you and work out what is going on. Usually it is nothing dangerous and I can reassure you. The important thing is you feel free to contact me. There is nothing worse than not knowing or worrying. 

You should contact my team immediately. I need to make sure it is not an infection. My infection rate is less than 0.5%, however it is better to be safe than sorry, so contact my team here.

Contact my team immediately and I will have a look for you.

There are several things that you may or may experience after spine surgery, and it is all normal.

• Pain at the operation incision site
• Some bruising around the operation site
• Minor bleeding into the dressing over the incision site
• Stiffness in the neck or back muscles
• For back operations, it is common to get muscle tightness also in the hamstrings and glutes
• For neck operations it is common to get muscle stiffness in the shoulders and back of the head
• Not feeling confident moving around freely
• The desire to rest, or feeling tired
• Some pain when moving around

Nerve pain usually improves quickly, but numbness or weakness takes much longer to improve