Post Op

Dr. Katz post-op protocol

Spine Surgery Recovery:

After you undergo a spinal procedure, and prior to leaving the outpatient facility or hospital, you will be given instructions regarding your post-operative care. Below is an overview of post-op instructions for several common spinal procedures. You must follow all guidelines specific to your procedure in order to achieve the optimal post-surgical outcome.

Microdiscectomy:

Since your surgery will be done in an outpatient setting, these are important guidelines you should follow once you get home.

Have a comfortable place to rest for the first 12 hours. During this time, apply an ice pack to the incision site, either continuously or intermittently, to help reduce swelling and pain. You are encouraged to take your medication as prescribed. Most patients experience significant leg pain relief in a day or two; however, some patients may still have some pain for several weeks. Numbness is common after a microscopic discectomy and usually resolves (disappears) within a few days to a few months.

By the next morning, you should be able to walk around and do some mild stretching. Restrict activities for the next 10-14 days. Sitting should be limited to 30-minute intervals to avoid stressing the disc and to avoid aggravating your lower back. Wear ted support stockings for one week and take a 325mg enteric-coated aspirin daily, if possible. On day 5, remove your bandage and then you may shower. Bathtub use is permitted on day 7, provided there are no exposed sutures. If you experience any drainage, clear or yellow fluid, from your incision, call your doctor. Spot bleeding on the bandage is normal; however, if it saturates your bandage call your doctor.

A follow-up appointment is required at about 10-14 days after your surgery.

Kyphoplasty:

Since your surgery will be done in an outpatient setting, these are important guidelines you should follow once you get home.

Have a comfortable place to rest for the first 12 hours. During this time, apply an ice pack to the incision site, either continuously or intermittently, to help reduce swelling and pain. You are encouraged to take your medication as prescribed. Most patients experience considerable relief from their back pain within a day or two. However, it can take up to 6 weeks for the pain to resolve. If you are not on a bisphosphonate (such as Fosamax or Boniva), please notify your doctor.

By the next morning, you should be able to walk around and do some mild stretching. Restrict activities for the next 10-14 days. Please be mindful that there is always a risk of developing another compression fracture due to your osteoporosis. Wear ted support stockings for one week and take a 325mg enteric-coated aspirin daily, if possible. On day 5, remove your bandage and then you may shower. Bathtub use is permitted on day 7, provided there are no exposed sutures. If you experience any drainage, clear or yellow fluid, from your incision, call your doctor. Spot bleeding on the bandage is normal; however, if it saturates your bandage call your doctor.

A follow-up appointment is required at about 10-14 days after your surgery.

Anterior Cervical Discectomy-ACDF

After your surgery, you will be admitted to the hospital for about 36 hours. Your neck drain will be taken out the morning after your surgery. Provided you are tolerating some liquids and food, not having a fever, and moving around the room you will be discharged the day after your surgery.

You may be required to wear a brace in order to allow your fusion to heal. Keep your incision covered with the bandage from the hospital for 5 days before removing it. On day 5, remove your bandage and then you may shower. Bathtub use is permitted on day 7, provided there are no exposed sutures. If you experience any drainage, clear or yellow fluid, from your incision, call your doctor. Spot bleeding on the bandage is normal; however, if it saturates your bandage call your doctor.

By the end of the first week, you should experience relief of your arm pain. However, you may continue to experience some posterior neck pain and a sore throat. This is normal and will resolve in a couple of weeks. In addition, you may experience some catching with swallowing. Again, this is normal and should resolve in a couple of weeks.

Do not drive and restrict activities for 6 weeks. A follow appointment is required 10-14 days after your surgery and again at 6 weeks after your surgery. At 6 weeks, you will be able to go back to most regular activities, and you will most likely be discharged at that time. Remember that smoking is not permitted for 6 weeks.

Lumbar Fusion:

Your lumbar fusion is a big operation whether it is done open or by the MIS (minimally invasive surgery) approach. After surgery, you will be admitted to the hospital for anywhere between 3-14 days, depending on the specific nature of your recovery.

First of all, this is a painful operation and you will require pain medicine for several weeks. While in the hospital, you will receive IV and IM pain medicine, and upon discharge, you can be converted to long acting pain pills. In order to be discharged, you will need to be comfortable on pain pills taken by mouth, have no fever, be able to eat solid food, and demonstrate the ability to walk, with or without a walker or cane. Your back bandage will be changed before you leave. You can remove your new bandage 5 days after being discharged from the hospital, at which time you may shower or bathe.

Recovery from this surgery will take a long time, approximately 8-12 months. You will be given pain medicine for the first 6 weeks and then you will be weaned. Your back and leg pain may take several weeks to several months to improve, so you will have to be patient as your fusion heals. Remember that smoking is not permitted for 6 weeks. Your activities will be restricted for the first 3 months and then you will begin a physical therapy program, either water aerobic, land-based or a combination of both. Sometimes a bone stimulation device will be used to aid in the healing process. Your first post-op visit is 10-14 days after surgery, at which time X-rays are usually taken to see the hardware (screws and rods). You will have periodic post-op appointments to monitor your progress. Back stiffness and/or pain are normal as you slowly improve and advance to more activities over the next several months. There may be certain activities that you may not be able to perform and this is not unusual. Be patient and careful, as your recovery will take time. The ultimate goal of this surgery is to reduce and/or resolve your back and leg pain.

The aforementioned information is meant as general post-operative instructions for common spine procedures. All spine surgery patients should follow the specific guidelines and instructions recommended by their own doctors.