Why do doctors always "shake hands" with you after spinal surgery?

I believe everyone is familiar with the scenes of doctors and patients shaking hands and making rounds in film and television works. After the operation, the surgeon needs to go to the patient's side for rounds, so as to know the patient's postoperative recovery in time and adjust the treatment strategy in time. ?

So imagine what the doctor's rounds will be like after spinal surgery?

Is that so?

Still like this?

In fact, after spinal surgery, doctors not only pay attention to the patient's vital signs, such as heartbeat, blood pressure, body temperature and other indicators, as well as the drainage and healing of the surgical incision, but also like to pay attention to the patient's feet (including the whole lower limbs), and even like to pinch and poke the patient's feet, which makes patients and their families puzzled.

Although you are curious, you must be full of questions. What's going on here? Listen to me slowly.

0 1, in the first case

Feel the skin temperature of lower limbs (left) and judge the blood supply of lower limbs. If the patient has a drop in skin temperature of lower limbs, he will feel whether the pulse of dorsalis pedis artery is good (right), and then the doctor will further consider the reason. If it is caused by insufficient heat preservation measures, the patient will be told to cover the quilt and pay attention to keep warm; If the toe and distal foot temperature is low, accompanied by weak pulse, rapid heartbeat or even cold sweat, the patient's blood pressure is low, circulation ability is insufficient, and even shock occurs. If the pulse of dorsalis pedis artery is obviously weakened or even disappeared, it is highly suspected that arterial thrombosis has occurred. Once it is confirmed that arterial thrombosis blocks the arteries of lower limbs, it is necessary to contact vascular surgery for emergency operation and remove the thrombus.

Left: Feel the skin temperature of the patient's limbs by hand. Right: Palpation of dorsal foot artery.

02, the second situation

Left: Leg swelling after deep vein thrombosis. Right: Depressed edema in front of the calf.

According to a study, the probability of deep vein thrombosis is 2.9%- 14% if spine surgery is not involved. The biggest harm of deep venous thrombosis of lower limbs is pulmonary embolism caused by thrombus shedding, which is a great threat to patients' lives. Therefore, active prevention and early detection of deep vein thrombosis after spinal surgery is one of the key issues after surgery.

03, the third situation

Check the nerve recovery after operation. Many spinal diseases can cause abnormal sensation of lower limb skin. Before the operation, the doctor will check and record the feeling of the skin with a percussion hammer, and there may be slight discomfort when the needle crosses the skin. After the operation, the doctor can touch the part with abnormal sensation before the operation to check the change of sensation, which can not only reduce the discomfort caused by using tools to check patients, but also evaluate the sensation of lower limbs conveniently and quickly. Some patients with lumbar disc herniation will have a positive straight leg elevation test. This is because the lumbar nerve root will be pulled when the patient's lower limbs are straightened and raised. If there is compression or nerve root edema at the exit of lumbar nerve root, there will be nerve radiation pain when the lower limbs are raised. Examining the elevation of straight leg after operation can judge whether nerve root decompression is complete and the recovery of neurological symptoms after operation.

In the straight leg elevation test, the knee joint is extended to raise the lower limbs, and it is positive if sciatica is induced. At the same time, it is necessary to record the height of the mark. The smaller the elevation, the heavier the compression of nerve roots. 2. Strengthen the experiment

When the pain is obviously relieved or just disappeared, the ankle joint bends back and induces pain again, which is a positive reinforcement test.

Therefore, don't underestimate the little gesture of "holding your feet" by spinal surgeons after operation. They can provide doctors with a lot of physical information of patients and provide important reference for doctors to specify diagnosis and treatment plans.