Pre/Post Op - Posterior Cervical Fusion - Dr. Kim
PRE OP INSTRUCTIONS
Posterior Cervical Fusion - Dr. Kim
Please remember, even though you and your doctor have decided to move on to surgery for treatment, there is a large amount of work and time that goes into getting your surgery approved and coordinated. We thank you for your patience. Before you have surgery there are certain things that should or need to be met. Consult the following list to make sure that you are ready for the day of surgery.
Physical examinations need to be completed within 30 days of your scheduled surgery. These exams are done by your primary care physician or internal medicine doctor and will be scheduled for you.
Nothing by Mouth
Please remember that you should not eat or drink anything starting at midnight the night before surgery.
Please ask at your pre-op physical or refer to the hand out we gave you to see if your medication should be continued until the day of surgery or stopped.
Often a brace or collar is given the day before surgery. Generally this appointment is made for you.
(methicillin-resistant Staphylococcus aureus)
MRSA is type of bacteria resistant to antibiotics. It is common to screen for MRSA prior to surgery to try and avoid unexpected complications.
Pre-op labs are required within 48 hours of the day of surgery. These must be done at the facility you are having surgery at.
Many hospitals provide vouchers for the nearby hotels. Contact the hospital you will be having surgery at to ask about possible vouchers for discounted rates.
Things to Remember
- Hand carry imaging of the area you are having surgery on. Often your doctor brings the required images, but any back up or help is appreciated.
- Wear and bring comfortable clothes
- Cell phone to call friends and family for rides, post op status, etc.
- Make sure you have rides to and from the hospital
- Walker or assist device
- Paper and pen for writing down any questions you may have; to assure that they are answered.
- Directions: know how to get to the hospital to avoid any obstacles in getting there.
POST OP INSTRUCTIONS
Posterior Cervical 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 creating room for the nerve so the nerve is not rubbed; 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 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 approximately a year for a fusion to solidify, due to this please remember to follow your restrictions and use common sense.
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
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.
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 occasiona lly made for you prior to
discharge from the hospital by the nursing staff. 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.
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 lbs. first two weeks, then not over 16 lbs. after that. We will clarify on further restrictions at your follow up appointment. We highly recommend not lifting anything over shoulder height.
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.
You have a horizontal incision on your neck; this was sewed under the skin, and then 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 100.3Ë�F. If any signs of infection do appear, please contact our office and/or your primary care.
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 patients go back to work with restrictions 2-4 weeks after surgery. If you have a more physically demanding job, this may need to be extended. In these cases, 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.