Bone Growth Stimulator – A bone growth stimulator uses electrical signals to stimulate the bone growth process after surgery, which increases the rate of fusion x and speeds up the healing process. A bone growth stimulator will be prescribed if appropriate and covered by insurance. Smokers, multilevel fusions, and immune suppression are typical indications for a stimulator. If you were fitted with a bone stimulator, you will need to use the device 2 hours a day for 12 weeks.
Smoking – You should not smoke for 3 months after surgery. Smoking negatively affects the blood supply to your bones and significantly slows down the fusing and healing process. Once you have stopped smoking, we recommend you remain smoke free for the rest of your life.
Home – There are no modifications required for your home. The physician determines any modifications and/or special equipment needs at the time of discharge from the hospital. It is recommended that you make arrangements for someone to stay with you the first week after surgery, in case you need assistance. Not all patients will require assistance in the postoperative period.
Incision – Your incision should be kept clean and dry. There are two methods to close the incision:
Staples – If you have staples, you should clean the incision with alcohol and change the dressing daily. Shower daily, pat the incision dry, clean with alcohol and reapply a new dressing. The staples will be removed approximately 7-10 days after you are discharged from the hospital. Call our office to schedule the staple removal (by our clinical staff) or by your primary care physician.
Dermabond (skin glue) – If you have dermabond, you should clean the incision with soap and water daily. The incision should be kept clean and dry. The incision may get wet in the shower and should be patted dry and cleaned with alcohol. Most incisions will have buried sutures and the skin edges will be glued together with Dermabond. Avoid using petroleum based products on the incision for 10 days after surgery. Bruising is very normal in fusion operations closed with this method.
Pain – It is normal to experience residual pain in your back and legs, as well as numbness and tingling in your legs. This should resolve with time as your body heals. A prescription will be given to your when you are discharged from the hospital. The oral medication should control your pain over the first several days. If you have any medication questions or needs please use our medication voicemail is available Monday – Friday 8:30 am – 4:00 pm. Prescriptions for pain medicine cannot be changed or refilled outside of our regular office hours or through the answering service.
Activity – Do not sit or stand for longer than 60 minutes during your first week after discharge. We do want you up and moving around the house. Begin a walking exercise program in the days after your surgery. Start with a 5-10 minute walk. You should walk on a level surface and try to build your walking program up to 30-45 minutes a day by the end of the 1st month after surgery.
Driving – You may be driven after discharge, but we prefer you not to drive yourself OR only drive short distances for 2 weeks. Do not drive under the influence of pain medications or muscle relaxers. You should not drive until you are off the pain medications and can drive safely and comfortably. If you are going a significant distance upon discharge, please stop every 45-55 minutes to walk around the car a couple of times to prevent stiffness and soreness, and reduce the risk of blood clots for the first 4-6 weeks.
Return to Work – The recuperation period is generally 2-3 months. If you are not involved in strenuous labor, you may be able to return to work within the month. If your occupation is physically strenuous, it may require that you be off work for 3 months. Returning to work is discussed further in your first postoperative visit. Physical therapy is prescribed in some cases when recovery is slow.
Urinary Retention – Inability to empty your bladder is common after anesthesia, especially for spinal surgery. It can be incredibly uncomfortable. If associated with increasing numbness or weakness retention or incontinince can represent a surgical problem, but this is rare. Most of the time, medications and/or placement of a catheter with a period of bladder rest will solve the problem. If you are having trouble and unable to urinate, please call and go to a convenient emergency room.
Drainage – A small amount of drainage from the drain site is normal for several days, but the incision line should be dry after the first 3-4 days.
Infection – Although rare, an infection can occur after surgery. The bacteria usually comes from the patient’s own skin. If you have any drainage or increased tenderness or redness around the incision, please call our office. Treatment requires a course of antibiotics and possibly additional surgery. Infection will prolong your recovery period.
CSF Leak – A cerebrospinal fluid leak from the lining that surrounds your spine may occur. This is unusual, but is more common if you have had previous spine surgery. If a leak does occur, it is treated with the placement of a drain near the incision site and several days of complete bed rest in the hospital.
Paralysis/Nerve Injury – This complication is extremely rare, but the surgery does involve the spinal cord and nerve roots. Paralysis is usually partial and temporary but cases of permanent paralysis have been reported.
DVT – After surgery blood clots in the legs can occur. These usually present as a painful swollen leg. If you think this could be happening you will need an ultrasound to diagnosis the problem. You should go to the closest emergency room to have this evaluated as it can be a life-threatening problem. If you do have a DVT it is treated with blood thinners.
Medical Complications – After surgery and anesthesia there is an increased risk for medical problems such as heart attacks, kidney failure, pneumonia, stroke and even death. If you feel you are having an emergency, please go straight to the closest emergency room.