Post-Operative Instructions for Major and Minor Spine Procedures

 

 

Minor Procedures include a collection of minimally invasive diagnostic tests and treatments.   Carpal tunnel and ulnar nerve surgeries are considered minor.  Major procedures include operations that ordinarily require a hospital stay.  Back and neck surgeries are major procedures.

 

You will need to do several things after the procedure.  These include:

  1. Arrange for a ride home;

  2. Set up your house for your recovery;

  3. Get your medications.

  4. Expect to take extra pain medications;

  5. Call us if you have a fever over 101 degrees, drainage from your incision, or uncontrolled pain;

  6. You will need to see us in the office about a week after you get home; and,

  7. Special instructions for particular procedures.

 

Print out this page and use it as a check-list so that you do not forget anything.

 

q Arrange for a ride home;

 

A responsible adult must take you home.  We are not allowed to send you home by taxi.  This rule is enforced for your safety.  If anything worrisome happens, your companion will be available to help you.

Special instructions:




 

q Set up your house for your recovery; and,

 

If you need a major surgery, such as a fusion, it is a good idea to have a bed on the first floor of your house.  You will want to be near a bathroom and you will want a telephone nearby.  The discharge planning nurse will help you arrange for any unforeseen extras which might be needed.  These might include a hospital bed, a toilet seat extension or a reacher-grabber so you do not have to bend.

 

Special instructions:




 

q Get your medications.

 

We will either give you the medications in the office before surgery, or we will give you a prescription.  This will depend on your insurance.  If you get a prescription, fill it before surgery so that you will not need to stop on the way home from the hospital or surgery center.

 

Special instructions:




 

q Expect to take extra pain medications;

 

Most of our patients have been using some pain medication before surgery.  You should expect to need more afterwards.  Be careful not to take more than nine Vicodin pills per day or twelve Norco pills per day.  The Tylenol they contain is dangerous in excess.  It is appropriate to use the pain medications (Norco or Vicodin) with the muscle relaxants (Soma, Valium or Flexeril) and the non-steroidal medications (Motrin, Naprosyn, Lodine, etc.).  They are designed to work together as long as you follow the instructions on the bottles.

 

After the surgery you should restart most of your normal medications.  Aspirin may begin immediately after back surgery.  For diabetics, you will need to regulate your medications depending on eating.  For those on blood thinners, the doctor will tell you when to restart those medications. 

 

Most pain medications cause constipation.  Take a little extra Metamucil, Senokot, Dulcolax or other over the counter laxative.  Follow the instructions exactly.  Too much laxative can cause dependance.

 

Special instructions:




 

q Call us if you have a fever over 101 degrees, drainage from your incision, or uncontrolled pain; and,

 

After the surgery expect that, in addition to some pain, you may have a few other complaints.  Sweating, flushing, insomnia, upset stomach, menstrual changes and flu-like symptoms are common. 

 

It is helpful to put ice on your incision.  Put the ice in a plastic bag so that the bandage does not get wet.  Heat is also good if it relieves your pain.  Do not ever fall asleep with a heating pad.  A heating pad can cause third degree burns.

 

Avoid excessive exercise and rest until we tell you.  Usually we will send you to physical therapy to help you start an exercise program. 

 

Patients will stay off work for a week following most blocks, for six to twelve weeks after disc surgery, and for at least three months after a fusion.

 

Special instructions:




 

q You will need to see us in the office about a week after you get home.

 

If you are not sure when to come in, call us.  We will need to see you about a week after you leave the hospital or surgery center.  When we see you we will give you more instructions to help you recover faster.  Specific instructions for each common procedure are listed below.

 

Special instructions:




 

q Special instructions for particular procedures.

 

q If you have gotten an epidural or selective nerve root block, expect to have soreness in the back.  Even a needle causes a bruise. Your leg pain should get better quickly and the soreness in the back will go away in about a week..

 

q If you have had a discogram, you will have a sore back.  The soreness will last about a week.  A discogram is a test.  It is not a procedure that relieves pain.  When you see us after a week we will be able to tell you if another procedure will be able to relieve your pain.

 

q If you have had an IDET procedure for a bad disc, the back pain may be worse after surgery.  It can take as long as a month for the pain to go away.  Patience and pain medications are needed for the first week.  Ice or heat will help the soreness.  After your first visit, physical therapy for stretching exercises will be recommended.  If you develop weakness or numbness in the legs, or problems with bowel and bladder, call us immediately.

 

q If you have neck surgery, wear your collar when out of bed.  For your sore throat you can use anesthetic cough drops or lozenges.  Try Cepacol with anesthetic.  Ice cream (or just sucking on ice cubes will help).  Do not each crunchy foods for a few days.  You can shower without the collar three days after surgery.  Do not drive until you no longer need your collar and are off of your pain medications.  If you have excessive drainage, call or go to the emergency room.   If you develop weakness or numbness in the arms, or problems with bowel and bladder, call us immediately.

 

q If you have had a back surgery without a fusion, you will not need a brace.  Walking is good.  Stretching is better.  You can sit for meals and take short rides in the car.  Do not drive until you are off of your pain medications.  If you have excessive drainage, call or go to the emergency room.  If you develop weakness or numbness in the legs, or problems with bowel and bladder, call us immediately.

 

q If you have had a back surgery with fusion, wear your brace when out of bed and remove it for showers.  You can shower three days after surgery.  Walking is good but stretching is not.  Do not drive until you no longer need the brace and are off of pain medications.  If you have excessive drainage, call or go to the emergency room.  If you develop weakness or numbness in the legs, or problems with bowel and bladder, call us immediately.

 

q If you have had a carpal tunnel surgery or an ulnar nerve surgery, keep the arm elevated for at least 48 hours.  Ice cubes wrapped in a plastic bag and a towel works well.  Be careful not to wet the bandage.  If you do get the bandage wet, come in and we will change it for you.  Do not do anything strenuous with the arm until at least three or four weeks after surgery.  If you have excessive drainage, or if you develop worsening weakness or numbness in the arm or hand, call us immediately.

 

q If you have had a myelogram you should do the following:  1.  Light activity for 24 hours after the procedure,  2.  Drink plenty of fluids,  3.  Expect a bit of soreness in the back,  4.  Occasionally some soreness in the arms or legs will last a day or two,  5.  If you have headaches, call the doctor.  You may need something called a blood patch.  6.  And, f you are on any antidepressant or phenothiazines, you can restart them 48 hours after the myelogram.

 

Special instructions:




 

Go to the chapter on minor procedures.

 

Go to the chapter on major procedures.

 






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Last modified: 07/27/08