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Post Op - ACDF Fusion - Dr. Kim

POST OP INSTRUCTIONS

ACDF Fusion - Dr. Kim

Description of Procedure

There are many techniques used to fuse the spine, your surgeon will choose the type that he/she feels will bring the most amount of relief while reducing the risk of the surgery as much as possible. Although fusion techniques differ the goal remains the same, to stabilize the spine, reducing pain down the arms and/or upper back and neck. This is done by making room for the nerve so that the nerve is not rubbed, and by placing material to eventually "fuse" (meaning grow bone from one bone to the next, so there is no longer a joint that can move) the bones to stabilize the spine and hopefully keep you pain free. As the bone heals from one bone to the next, just like how a cast would be used to splint a broken arm, a cast or support system is needed here too. To accomplish this, a framework of screws and a plate are used to support and provide a stable environment to promote bone healing. It takes roughly a year for a fusion to solidify, due to this please remember to follow your restrictions and use common sense.

Neck/Shoulder pain

Headaches, neck pain, pain near and around your shoulder blades and into your arms, as well as a sore throat and swallowing that seems to "catch" are common post- operative pain/symptoms after a neck surgery. These symptoms are typically temporary and can take quite some time to resolve.

Arm pain

It is common to experience temporary increased or the same level of intensity of pain down one or both of your arms or shoulders. This can be due to us "cleaning off" your nerves, swelling, or just remnants of nerve irritation from prior to surgery. Please inform us however, if your pain is gradually worsens.

Appointments

Please see your primary care physician one week after surgery to have the incision examined. We would like to see you at
Tristate Brain and Spine institute one month after surgery.
These appointments are typically made for you before you are discharged from the hospital by the nursing staff. Occasionally, the appointment is not made if you are discharged from the hospital over the weekend. Please ask the nursing staff or
contact our office to confirm these appointments. You should have plain X-rays whenever you come back to clinic for visits. You can reach Tristate at (320) 763-8888 to set up an appointment with our Patient Access Representative team.

Restrictions

Do not bend or twist you neck. Remember this acronym "BLT". That is you should not Bend, Lift over 8 pounds, or Twist. We would like you to keep your cervical spine (meaning shoulder to head) as straight as possible. Do not lift over 8 pounds the first two weeks, then not over 16 pounds after that. We will clarify on further restrictions at your follow up appointment. We highly recommend not lifting anything over shoulder height.

Medication Refills

The medications may not last until your one-month follow up appointment. Please have your pharmacy send us a refill request to our fax (fax # 320-200-7478). If the pharmacy is unwilling to send a fax, please give us a call. Many medications are monitored; it will speed up the process if we get the request from your pharmacy. Due to this monitoring, please allow ample time for medication requests such as these (narcotics) to be received, reviewed, and mailed to your pharmacy. Since many substances are controlled prescriptions, please expect drug screening at random intervals.

REMINDER: We prescribe post-operative medication for up to 90 days; use this time to set up other pain management services if medications are still required after the 90-day period.

Incision Care

You have a horizontal incision on your neck; this was sewed under the skin and covered with a type of medical glue, which helps prevent infection. No care is needed for the incision, just simply leave it open to air and keep an eye on it for any signs of infection.

Signs of Infection

You or a significant other/caretaker should monitor your incision for signs of infection. Signs of infection are redness, swelling, increased warmth to the touch, discharge from the wound, and a body temperature over 100.3˚F. If any signs of infection do appear, please contact our office and/or your primary care.

Delayed Healing

If there is concern about delay in fusion then CT scans should be obtained. Certain things can delay your healing, stop your surgery from being successful, and/or increase your risk of requiring another surgery. These things include smoking or
tobacco use, diabetes, poor general health, advanced age, and/or obesity. Some of these risks cannot be avoided, remember to control what you can for the best possible outcome.

Can I bathe?

You may get the incision wet in the shower, just pat dry the site with a clean towel when finished. However, avoid soaking in the bathtub. You do not want to soak the wound in water; this will increase your risk of infection at the incision site. Please wait around 3 weeks when the incision wound is well healed before taking baths to bathe.

Should I wear a brace?

Brace should be worn until fusion is solid. Physical therapy will start at 3 or 6 month follow up and that is typically when the brace is no longer used.

When can I go back to work?

Most patient go back to work with restrictions 4-8 weeks after surgery. If you have a more physically demanding job, this may need to be extended. In this case, your capability to return to work can be discussed at your one-month visit.

When can I drive?

Abstain from driving until off all narcotic pain medication. Once off medications, you should be able to safely operate your vehicle once again.