Post Op - Lumbar Fusion - Dr. Kim
POST OP INSTRUCTIONS
Lumbar 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 legs and/or lower back. This is done by making room for the nerve so 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 rods 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.
Back pain is expected after surgery, typically in the lower back and can seem to radiate into the hips. This is normal post-operative pain.
It is common to experience temporary increased, or the same level of intensity, pain down one or both of your legs. 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 worsening.
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 occasionally 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 spine. Remember this acronym "BLT". That is you should not Bend, Lift over 8 pounds, or Twist. We would like you to keep your back (hips to shoulders) as straight as possible. Do not lift over 8 pounds first two weeks, then not over 16 pounds after that. We will clarify on further restrictions at your follow up appointment.
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.
Depending on the type of surgery, you may have staples, sutures, steri strips, or likely a combination of these to help close your incision post operatively.
Steri strips are small stickers placed over the wound; please allow these to remain in place until they fall off on their own.
Staples should be taken out within 2 weeks post op either with your primary care doctor or at our facility.
Often a tan bandage is placed over the incision site after surgery. This is left on for 6 or 7 days, then should be removed. After, gauze or bandages are usually not necessary. We ask that you leave the site open to air unless you find that there is increased sweat or moisture in the area, and then please apply an antibiotic ointment and dressing 2 times per day until the environment is not moist or the 3 weeks have passed since surgery. Please remember that dark and moist areas promote bacterial growth.
Signs of Infection
You or a significant other/caregiver 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.
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.