What to Expect After Minimally Invasive Spinal Foraminoscopic Surgery (Doctor’s Edition)

1, postoperative medication: postoperative routine application of broad-spectrum antibiotics for at least 1 day; dehydration drugs (such as mannitol) available, not more than 3 days, but for the elderly, cardiac and renal insufficiency of patients should be used with caution; hormone drugs (dexamethasone, prednisolone) available for 3-5 days, is prohibited for diabetic patients; available anti-inflammatory and analgesic drugs such as fenpropidone, ibuprofen, COX-2 inhibitors, such as clonoxicam; available Blood circulation and blood stasis activating drugs. Diabetic patients should be more important to monitor and control blood glucose after surgery. Patients who take aspirin before surgery can continue to apply aspirin drugs for 3 days after surgery. 2, postoperative diet: due to the local anesthesia for the operation, you can eat and drink after the operation. There is no special contraindication to general diet, but alcohol is prohibited for 3 weeks after surgery, and it is better not to eat fish, shrimp, crab, spicy and stimulating food. Diabetic patients should continue diabetic diet after surgery to effectively control blood sugar. 3, postoperative rehabilitation: in order to reduce postoperative swelling reaction, it is recommended that at the end of the operation, the doctor will place a drainage tube in the patient’s surgical site, which will be removed 24-48 hours after the operation. Patients should stay in bed for 3 days after surgery, try to urinate and defecate in bed, try not to sit up, stand up and walk, and wear a waist cuff if necessary. When eating, the patient can lean on the bed and should wear a waist cuff. During bedridden period, should be appropriate to do hook feet, leg lifting movements, each time 20-30 times, 2-3 times a day, if the elderly have difficulties, the family or accompanying staff can assist in completing, but also to help the patient appropriate massage of the lower limbs or waist. After 3 days of surgery, the patient can have appropriate activities, such as going to the toilet, sitting by the bedside to eat, walking on the ground, etc., but he/she must wear a waist cuff. 3 days after surgery to 7 days after surgery should be more bedridden, in bed to perform functional exercises, the same as before more hook foot, straight leg elevation training, and gradually increase the number of times and frequency than before. On the 3rd postoperative day, blood can be drawn to recheck the routine blood test, blood sedimentation, C-reactive protein, if the result is normal, usually in 5-7 days after the operation, discharge. After discharge from the hospital, the patient should go down to the ground and stay in bed for 3 weeks, and then gradually increase the amount of activity after 3 weeks. After 3 weeks, gradually increase the activity. After 3 months, wear a waist cuff for 3 months, and after 3 months, wear a waist cuff when sitting in a car or working. 4.About “postoperative recurrence period”: some patients will have their original symptoms reappear or even aggravate in about 3-4 weeks after the operation, generally the possible reasons are: increased activities after the operation; not wearing the waist cincher according to the doctor’s instruction; not taking medicines for activating blood circulation, removing blood stasis and relieving pain, and so on. After the symptoms of “postoperative recurrence period” appear, the patient should communicate with the doctor in time or come to the hospital for consultation. According to the patient’s situation, the doctor can give anti-inflammatory and analgesic drugs, blood circulation and blood stasis, most of them can be relieved or recovered, if necessary, the sacral tube can be closed or intravenous drip dehydration, swelling, pain, hormone drugs. If the symptoms are abnormal and obvious or continue to aggravate when you are in bed, you should review the nuclear magnetic resonance examination to see if there is infection, end plate inflammation, hematoma formation, or the prolapsed nucleus pulposus tissue is not removed cleanly or the residual tissue in the disc is prolapsed to the vertebral canal again, and at this time, the treatment plan has to be changed, and the treatment cycle will be prolonged. 5. About the phenomenon of “lagging imaging changes”: most patients have obvious improvement of symptoms after surgery, but there is little change in the short-term review of MRI and CT, which is the so-called “phenomenon of lagging imaging changes”. The reason may be that laminectomy is a limited decompression surgery, coupled with the postoperative edema reaction, so the changes are not obvious on ordinary X-rays, CT or MRI, but the changes can be seen on CT reconstruction of the articular eminence, lateral fossa, or intervertebral foramen. Generally, after six months to one year after the operation, the review of CT or nuclear magnetic can see obvious changes. 6. Post-discharge medication: It is recommended to use anti-inflammatory and analgesic drugs, blood-activating drugs and neurotrophic drugs for 3 months after the operation to facilitate the smooth transition through the recurrent period and reduce the postoperative symptoms. If it is convenient, you can have a review every 2 weeks in the outpatient clinic within 3 months after the operation, or communicate with your doctor by phone. 7. Rehabilitation training after discharge: It should be carried out gradually and in accordance with the doctor’s instructions. If the condition permits, it can be transferred to the rehabilitation department for massage, physical therapy, hot packs and other related treatments. Rehabilitation exercises can also be carried out by yourself: insist on doing the “swallow fly” movement of tilting the head and lifting the waist every day (it is better to be slow and soothing), 20-30 times each time, 2-3 times a day; lower your head, bend less, do not sit for a long time and stand for a long time, and do not bend down to lift heavy things. Do not engage in long-term bending or long time squatting work or activities, such as not long time Internet, long time playing cards, long meetings, pulling weeds and so on. You should also not be absolutely bedridden without any exercise after discharge from the hospital. You should keep in touch with your doctor within 3 months after the surgery in order to guide the medication and rehabilitation exercise. 8.Re-check and follow up: After surgery, you should come to the hospital for review and follow up in the 3rd month, half a year and 1 year, and bring the preoperative imaging data with you when you come to the hospital, or communicate with the doctor on the phone when it is inconvenient. Follow-up visit includes simple inquiry, physical examination, imaging examination, etc. The content of each visit varies and is specifically formulated according to each patient’s situation.