Lumbar Fusion/Anterior or Posterior Cervical Fusion
Please contact our office at (214) 782-9222 to schedule an appointment 2 weeks from the date of your spinal surgery (if not already scheduled).
- Wound Care/Sutures. The surgical dressing will be removed before discharge from the hospital. Do not apply creams and/or cleansers to the incision. There will be dermabond glue on your skin sealing the incision. This will peel off with time. Continue changing the dressing until all drainage from the wound stops. At that time, you do not have to cover your wound. However, if your incision is sensitive or your clothing is rubbing against your wound, you may apply clean, dry gauze to cover your wound. Report immediately any signs of drainage, fever, redness, swelling around the operative incision, or severe increased pain in any one of your extremities.
- Showers. You may begin showering as soon as you feel safe in doing so. It is alright to get the incision wet in the shower. However, do not submerge incision under water.
- Incisional Swelling. Swelling around the incision after surgery is normal. You may even notice a slight increase in swelling after activities. This will dissipate in time; however, please report any significant swelling, redness, fever, drainage or intractable pain!
- Post-Operative Blues. So you’re feeling better and the discomfort you’re in now is nothing compared to what you endured before surgery … or perhaps you feel quite the opposite. Many patients have verbalized frustration at not being able to resume normal activities – for example, driving, going back to work or participating in simple activities of daily living. Having to limit and curtail your activities, along with pain and discomfort, can leave you with the impression that you will never get better. There is a light at the end of the tunnel! Remember that your body needs to recover from major surgery. How you take care of yourself in the post-operative period will have direct bearing on the ultimate result. This is the time to take care of yourself. Rest, eat a well-balanced diet rich in protein, walk every day if possible, take a more positive attitude, and feel good about yourself. It takes a great deal of courage and determination to undergo what you have been through.
- Post-Operative Activities. Once you are home, the aerobic exercise permitted is walking. We strongly encourage this, and it should be done in a progressive manner as tolerated, in a safe environment, and on flat surfaces. Avoid any lifting greater than 5 pounds.
- First Post-Operative Examination. Upon your discharge from the hospital, please contact our office at (214) 782-9222 to schedule an appointment 2 weeks from the date of your surgery. At this appointment, sutures will be clipped if necessary, your wound will be checked and x-rays will be taken.
- Lumbar Brace. If deemed necessary by your physician, you may be required to wear a lumbar brace. It will be necessary for you to adhere to wearing your lumbar brace on a daily basis. You should wear your brace when you are on your feet and especially when you go out for a walk or ride in a car. Don’t be alarmed if you cannot tolerate wearing your brace during the initial post-op period. You may have residual inflammation and swelling around the surgical area which may make wearing the brace somewhat difficult. Give it time.
- Bone growth stimulators. After fusion surgery Dr.Farley may ask you to wear an external bone stimulator. This device assists in bone healing after surgery. Clear instructions on the bone growth stimulator will be given to you both before and after surgery.
- Cervical Collars. You will be instructed by your physician if it is necessary for you to wear a cervical collar. If instructed to do so, you typically will wear a cervical collar for a period of 6-12 weeks.
Things to Avoid
- Prolonged standing in one place and prolonged sitting are not recommended as this may cause increased soreness and/or stiffness. If you need to sit for a prolonged period of time, it would be wise for you to get up intermittently, walk around and stretch your legs.
- Avoid bending until otherwise instructed by your doctor.
- Do not lift objects over 5 pounds.
- Avoid movements that were not recommended. You will be given instructions by a physical therapist while in the hospital on proper body mechanics.
- Minimize the amount of time spent in an automobile.
- If an activity provokes any discomfort, don’t do it!!!
It is important that you take vitamin supplements post-operatively while your fusion is healing. We recommend that you take the following, with plenty of water: at least one Multi-Vitamin daily; 400 units twice daily of Vitamin D; and 500 mg twice daily of Calcium Citrate. You can obtain all of these at your local pharmacy, over-the-counter. A successful post-operative recuperation is, in part, dependent on your adhering to these instructions. Thank you for your cooperation.
Frequently Asked Questions
Below is a collection of frequently asked questions by spinal surgery patients. Please click a question below to reveal the answer.
When do I have to return to the office to see the doctor?
Plan on returning to the office 2 weeks following discharge from the hospital and then four weeks after that. The patient is to call and set up this appointment. The patient should notify the office if there are any questions or wound problems.
When can I sit?
You can usually begin sitting immediately after surgery. However, the sitting position is most likely to cause discomfort. We usually encourage patients when they do begin to sit to use a relatively high chair similar to a dining room chair with a firm back, open base and arms. The purpose is to allow the transition from sitting to standing without excessive bending of the hips. Recliners and couches are not advised because of the range of motion required to sit and rise from them. The length of time allowed for sitting is determined solely by the patient's endurance. Patients should avoid squatting positions.
What activities can I do at home?
You may pursue activities that are done at walking level intensity. The ones to avoid are those that involve hip bending, especially with the knees straight. Walking is one of the best activities and swimming is also good. During the initial postoperative period the patient should avoid pushing, pulling, squatting or heavy lifting. The patient may resume driving approximately six weeks post op.
Do I have to wear a brace all the time?
Lumbar Brace If deemed necessary by Dr. Farley, you may be required to wear a lumbar brace. Itwill be necessary for you to adhere to wearing your lumbar brace on a daily basis. You should wear your bracewhen you are on your feet and especially when you go out for a walk or ride in a car. Don’t be alarmed if youcannot tolerate wearing your brace during the initial post-op period. You may have residual inflammation andswelling around the surgical area which may make wearing the brace somewhat difficult. Give it time. You do not need to wear your brace when you are in bed or sitting in a chair.
Cervical Collar You may be required to wear a cervical brace after surgery, if it is necessary for you to wear a cervical collar you typically will wear it for a period of 6-12 weeks.
Bone Growth Stimulator After fusion surgery Dr.Farley may ask you to wear an external bone stimulator. This device assists in bone healing after surgery. Clear instructions on the bone growth stimulator will be given to you both before and after surgery.
What about going to the bathroom?
Usually an elevated commode seat is more comfortable for the bathroom. You may get a prescription for this before leaving the hospital.
What about transportation home?
Most patients are able to go home in a car. Some patients tolerate the trip better lying down in a van or car with reclining seats. If traveling very long distances, ambulance transportation can be arranged.
Do I need a hospital bed at home?
Very rarely will a hospital bed be indicated. Most patients will be comfortable with a higher bed for ease getting in and out.
When can I ride in a car and/or drive?
You may ride in a car relatively soon. Most patients' endurance is relatively low for the first few weeks or months postoperatively. The patient may travel best lying down in the car. Patients should avoid driving for approximately six to eight weeks.
Can I bend over?
You may not bend over from the waist with knees straight. Should it become a necessity to bend down, kneel on one knee so that one hip remains straight and one is bent.
Should I do exercises?
Yes, exercise should be encouraged. Range of motion exercises to the shoulders, hips, and knees are acceptable. Abdominal and gluteral strengthening are helpful for adults. Walking and swimming are strongly encouraged to help restore endurance and lost muscle mass.
Do I need to take vitamins, calcium or iron?
A balanced, nutritious diet is essential to the healing process after surgery. If you are currently eating a balanced diet, you do not need supplements. A multi-vitamin with iron may be helpful in some cases.
May I smoke after surgery?
Cigarette smoking must be avoided for the fusion to take place.
When can I return to work?
The time of return to work will depend on the type of work and the extent of surgery. For laboring activities requiring an eight hour work day with heavy lifting or strenuous activity, the amount of time required before returning to work may be as long as one year. For sedentary type work that can be started on a shorter schedule, the patient may be able to return to work as quickly as six to eight weeks
What symptoms should alarm me after I get home?
Symptoms that need to be addressed include: redness and drainage from the incision, fever, a change in the pain pattern, or any alteration in the sensation in the legs. Call the office at 214-782-9222 if any problems or questions arise and ask for the medical assistant.
Will I need someone to stay with me all the time?
Upon discharge from the hospital, the patient should be independent in daily self care activities. Help may be needed for heavy housecleaning. Typically, patients do not require 24 hour nursing car but home health care is available to many patients.
What about sex?
Most patients can participate in sexual intercourse very soon after surgery depending on their pain level. This is truly an individual decision. The consideration is to avoid twisting and excessive bending of the hips with any type of postoperative activity.
What are the most comfortable sleeping positions?
The most comfortable sleeping positions are on your back (a pillow may be used under your knees at home), on your side (with pillow between your legs), 3/4 turn on your stomach (pillow against your chest and one pillow between your knees) and on your stomach after you are discharged from the hospital.
What about pain medication?
A prescription for pain medication will be given at the time of discharge. If refills are necessary, the patient should have the pharmacy call the office during office hours. Prescriptions for medications, elevated commode seat, or ambulance, if necessary, should be obtained from the physician at the time of discharge.
When can you shower?
You will be given instructions when you leave the hospital. You can clean the incision with soap and water at almost any point after surgery but do not soak the incision in the bathtub or a swimming pool until at least three weeks post-operatively.