Spinal precautions include head holding, application of a cervical collar, patients. Spine protection and spinal motion restriction do not equal long spine board. Limit sitting, including in the car, to no more than 30 minutes at a time standingwalk breaks. Patients over the age of 65 with a mechanism of injury with the potential for causing spine inj ury will have a cervical collar applied even if the spinal injury clinical assessment is negative. Postoperative instructions anterior cervical fusion 1expect to be discharged the day following surgery, although occasionally patients stay for two days your insurance company may or may not allow that. These include application of a cervical collar, adequate securing to a stretcher, minimal movementstransfers, and maintenance of inline stabilization during any necessary movement.
The cervical spine consists of 7 vertebra in the neck. Aus trali a nda collec edfrom 200607 ind ca hat 52% per cent of juries were related to transport accidents and 29% were as a result of falls. Posterior cervical procedures are much more painful than anterior procedures. Initiate neutral spine core stability training on treatment table. These can also help bring the spine into better alignment in instances of a. The patients effort and collar are used for cervical stabilization. Cervical spine not clear of injury, thoracolumbar spine cleared in the early phase of management, the patient will require full spinal precautions unless otherwise documented. Flexion lift your arm above your head, keeping your elbow straight. Fluid resuscitation in neurogenic shock should be to euvolemic state. Revised 112015 your path to recovery after cervical spine. Caring for myself after anterior cervical spinal fusion what is anterior cervical spinal fusion. Continue soft tissue mobility, modalities, as needed. Lifting do no lift anything greater than 10 pounds, until cleared by your surgeon approximate weights. Generally, patients will be much slower to recover and return to activity.
This is done as an effort to prevent injury to the spinal cord. You may be given additional instructions by your surgeon when discharged. If you have any questions or problems please contact our office at 214 3518450. At your 6 week followup appointment in the clinic, you may be given a handout of neck. Here are some simple precautions that need to be followed post surgery to reduce the risk of infections and injury and hasten the process of healing, bed rest is a very crucial and vital aspect of post surgical care and patients are requested to limit their movements for the first few weeks following surgery. Cervical spondylosis is a common, typically agerelated condition that affects the joints and discs in your neck. Spinal precautions frequently refer to the immobilization of the cervical spine to prevent injury. Spinal motion restriction with cervical collar and securing patient to cot, while padding all void areas is appropriate. New guidelines suggest a more limited role for prehospital spinal immobilization based on increasing evidence that the practice often is not only unnecessary, but possibly harmful. As is the case for lumbar spinal stenosis exercise, exercises for cervical spinal stenosis also work to improve the strength and flexibility of the upper back and neck. Cervical postoperative instructions frank feigenbaum, md. The surgeon creates an incision in the front of the neck to reach the herniated disc and.
Light prom or stretching of cervical spine with pt only. Postoperative instructions anterior cervical fusion. Anterior cervical discectomy and fusion acdf your surgeon will remove a herniated or degenerative disc in the neck area of the spine. It develops from wear and tear of cartilage and bones and can cause stiffness. Initiate saggital plane core stability training, continue to avoid extension in cervical spine. Introduction in victoria, most spinal cord injuries sci result in permanent neurological disability for patientsi. Before your surgery date, hospital staff will collect cultures from you to check for staph by.
This handout gives guidelines to follow after spinal injury or surgery. Soft tissue mobility on thoracic, cervical, upper traps. Cervical spine immobilisation and management adult and. Without precautions, these organisms can unknowingly get into a staph carriers surgical incision following surgery. However, as in any clinical situation, there may be factors which cannot be covered by a single set of guidelines. Precautions avoid bending, twisting, lifting, pushing and pulling 25 pounds or more for six weeks. Initial efforts in the acutely injured patient with known spinal cord injury sci should focus on. The most important donts for cervical spondylosis is to avoid sleeping on the stomach, as sleeping in such a position can restrict the neck from resting in a naturally aligned manner. A cervical collar is used to provide support and limit movement of the neck. During the operation, a small incision is made, usually in the. Spinal precautions also known as spinal immobilization and spinal motion restriction, are efforts to prevent movement of the spine in those with a risk of a spine injury. Your surgeon will determine if you need a brace and the.
It is estimated that 2% of people with blunt trauma will have a spine injury. Highcervical nerves c1 c4 n most severe of the spinal cord injury levels n paralysis in arms, hands, trunk and legs n. Spondylosis patients should avoid making any sudden movements like twisting the neck or the body all of a sudden. Ems spinal precautions and the use of the long backboard resource document to the position statement of the national association. Caring for myself after anterior cervical spinal fusion. Do not lift or carry objects that weigh more than 5 to 8 pounds. Review cervical spinal precautions and neutral spine concept. Physical and occupational therapy after spine surgery. Patient management this document reflects what is currently regarded as safe practice.
Decrease inflammation, encourage wound healing and monitor for signs of possible infection low. A cervical discectomy and fusion is a surgical procedure performed on the cervical neck region of the spine to help relieve pressure on the nerves and, perhaps, even the spinal cord itself. The following should be documented following discussion with the managing unit. This surgery fixes of the bones in your neck together to steady it or prevent movement. Degenerative changes, or arthritis, in your neck can cause pain as well as disc bulges or herniations. How to care for yourself after posterior cervical spinal fusion what is posterior cervical spinal fusion. Education regarding spinal precautions and log rolling. Cervical spinal stenosis is a narrowing of the spinal canal in the neck, mostly in adults 50 years and older, and can cause pain and other problems. Spinalneurogenic shock may result from high spinal cord injury. The assessing clinician should therefore assume a second injury, and all patients with a significantly identified skeletal injury in the spinal column.
Spinal stenosis narrowing of the spinal canal causing pain abnormal curvatures of the spine weak or unstable spine injury or fracture to the spine types of fusions. Cervical spinal precautions may be ceased with a normal mri no clinical assessment is needed ongoing care. The johns hopkins spine service is dedicated to returning you to an active lifestyle. Advanced strengthening phase 12 16 weeks postop 1215 weeks postop. Spinal precautions washington university orthopedics. Page 2 of 3 activities of daily living after spinal injury or surgery occupational therapy box 356490 1959 n. Trauma clinical guideline cervical spine injury evaluation. Up to 20% of spinal injuries occur at multiple levels and there is evidence that in the upper cervical spine one identified injury is associated with an 80% chance of a second injury in the cervical spine fig. Spinal stabilization ex in supine, neck supported no bridging. The following guidelines are recommended after spine surgery to ensure a good recovery. Posterior cervical spinal fusion is fixing the bones in your neck together to steady it or prevent movement. A cervical laminectomy is a surgical procedure in which the ruptured part of a disc or a bone spur is removed to relieve pressure on the nerve.
Spinal precautions, also known as spinal immobilization and spinal motion restriction, are efforts to prevent movement of the spine in those with a risk of a spine injury. Postoperative precautions and wearing a brace can make some selfcare activities and activities of daily living difficult, if not impossible. A discectomy is the removal of the piece of disc or the entire. Pain radiation down the arms may be due to a disc bulge or disc herniation. No joint mobilizations within 2 segments adjacent to fusion phase iii. Yes requires radiography once a cervical collar has been applied, full spinal precautions need to be maintained until the.
Precautions avoid extension with anterior cervical fusion avoid flexion with posterior cervical fusion promote arom and avoid passive stretching limit cervical rom until 810 weeks phase i. Basic principles of management for cervical spine trauma. In most cases, a small incision is made in the back posterior part of the neck. Mriof the cervical spine should be performed as soon as the patient has been stabilized and can safely transferto the radiology department.
What is an anterior cervical neck discectomy and fusion. Always remember your spine precautions when exercising. How to care for yourself after posterior cervical spinal. Cervical spine surgery guide johns hopkins medicine. The changing standard of care for spinal immobilization. Good body mechanics will be needed overall for the rest of your life. The surgeon removes the back portion of the spine called the lamina, in order to open up the area for your spinal cord and nerves. Whether or not a backboard is used, attention to spinal precautions among atrisk patients is paramount. Wear your collar at all times or as recommended by your doctor. If they need to have head elevation this should be achieved by tilting the bed. Following trauma when patient communication is limited. The higher the injury on the spinal cord, the more dysfunction can occur.
Activities of daily living after spinal injury or surgery. Spinal stabilization ex in supine, neck supported no bridging upper extremity active motion arom to tolerance deep breathing exercises cervical arom in painfree range no prom no stretching gentle 2finger isometrics scapular retraction, shoulder shrugs, chin tucks stationary bike. Tmi posterior cervical laminectomy and fusion protocol. For this reason, your doctor may prescribe occupational therapy to assist you in learning alternate methods to perform these tasks. Canadian cspine rule for alert gcs 15 and stable trauma patient where cervical spine is a concern. Spinal precautions include head holding, application of a cervical collar, patients nursed in neutral. Craig humphreys jan 10, 2019 if youre a just the facts kind of person, heres a fact you might be interested in.