Guidance following scoliosis surgery

This information is intended as a guide for patients when they return home after surgery.

You will be given pain relieving medicines to take home on discharge which will be based on your individual needs. You should continue to take these regularly for the first two weeks or as directed. Regular pain relief may be necessary for four to six weeks.

You should continue the recovery and rehabilitation process at home. Try and avoid doing any activity for too long but move little and often. The trunk (back and abdominal muscles) will strengthen gradually and every so often they will get tired and ache. Usually lying down for a short period will relieve this so rest when necessary. As your body adjusts to your new posture, you will become more comfortable. You have to learn to do normal every day activities from your ‘new position’.

Sometimes when you start to increase your activity levels, your body is inclined to resume the old position, as it is more familiar. For example, when writing or eating, your right shoulder may be used to dropping forward. It is important to try to maintain the corrected posture and slowly teach yourself to work in this position.

Increase activity levels steadily as you are able over the next month. Consider returning to school or college or work when you are coping with a whole day up and about at home. Minimise what you need to carry. Make sure you have a comfortable chair to sit on (take a cushion if necessary) and avoid sitting still for too long. A flexible approach is helpful to avoid getting over-tired.

Five to eight weeks

• Consultant outpatient appointment and check x-ray.
• Physiotherapy rehabilitation programme will commence the same day (you will receive a letter soon after discharge from hospital with details.)

Activity guidelines

0-6 weeks

The aim in the first 6 weeks is to gradually increase the frequency and length of time spent sitting, standing and walking, and to decrease the amount of time spent lying and resting, as pain allows.

For comfort and ease, it is advisable to log-roll from lying to sitting.

Avoid:

• Lifting heavy objects, avoiding anything heavier than half a full kettle.
• Bending (to pick something up bend knees and keep back straight).
• Twisting motions.
• Sitting on low or soft chairs.

You may find that your shoulders and neck begin to feel a little stiff. It is advisable to do regular gentle exercises to help avoid this. You may find these difficult at first, so the repetitions are just a guideline. You should try to complete your exercises at least 4 times a day, beginning with a few repetitions and increasing as pain allows.

Exercises

Standing or sitting.

Gently push your shoulder blades down and back, in a "V" towards your bottom (imagine sliding shoulder blades down into back pockets).

Hold this position for 3 seconds.

Relax, then repeat 10 times.

Shrug your shoulders up towards your ears, then circle them back and down.

Repeat 10 times.

Lying down or sitting in a chair, take a deep breath in, trying to fill up your lungs and expand your chest as much as you are able to.

Repeat 3 times.

Standing or sitting. Turn to the left, then turn to the right. Repeat 5 times to each side

Standing or sitting, bend your head gently sideways towards your left shoulder, then bend your head gently sideways towards your right shoulder.

Repeat 5 times to each side.

Lying on your back. Link your hands together. Lift your arms up and over your head. Hold for 3 seconds, then bring your arms back to your sides.

Repeat 10 times.

Guidelines for returning to activities and sports:

4 weeks

Return to school / work part time (e.g. half days or every other day).

2 months

Patients will have a post-operative review appointment in clinic approximately 6 - 8 weeks post-surgery, with an x-ray on arrival. At this point you may be referred for physiotherapy to progress your rehabilitation.

After 3 months

• Increase time spent walking, increase pace as able.
• Aim to increase fitness with general exercise, as advised by your physiotherapist.
• Gently return to swimming and cycling.

6 months

• Further increase time and distance walking, increasing pace as able.
• Continue to increase fitness with swimming and cycling
• Non-competitive swimming, e.g. lengths of a pool
• Jogging - increasing to running as able
• Acceleration / deceleration and turning
• Non-contact sports

12 months

Competitive contact sport is usually acceptable at 12 months post-op, but you will need to check with your surgeon first.

Patients have regular follow up in the clinic with x-rays for a minimum of three years.

Contacts

Physiotherapists

• Sarah Charlton
  Email Sarah Charlton
• Claire Baker
  Email Claire Baker