The spine is a fundamental part of the body that allows us to move and function as healthy human beings. However, when the spine becomes injured or creates problems, such as back pain, it can severely limit our lives and disable even the strongest person.
Fortunately, advances in modern health care, such as spinal surgeries, have made it possible to treat many debilitating spinal conditions. With the help of spinal surgery many people have been able to take back control of their lives and live a happier, pain free existence.
What Can Spinal Surgery Treat?
Some conditions that spinal surgery can be used to treat are:
Back or leg pain
Herniated disc
Bulging disc
Bone spurs resulting from osteoarthritis
Lumbar degenerative disc disease
Spondylolisthesis
If you have been living with pain in your back or legs stemming from a spinal condition, spinal surgery may be the right treatment option for you. However, surgery is not something to be taken lightly and should not be rushed. First speak with your physician to make sure you are a good candidate for spinal surgery.
Once you and your doctor have decided that spinal surgery is the appropriate course of action to treat your back pain, it is time to get proactive about preparing for your surgery. Here is a comprehensive guide to help you feel confident and ready for your operation and your recovery. Remember when it comes to your health, there is no such thing as being over prepared.
Common Low Back Pain Surgeries
When it comes to surgery used to treat pain in the lower back or legs, there are a few surgeries that are commonly used. The three most common forms of low back pain surgery are lumbar fusion, lumbar laminectomy, and lumbar discectomy.
These surgeries use different approaches to treat spinal conditions and it is important to have a good understanding of how each type of surgery works and is performed. Educating yourself on the different procedures will help you and your surgeon choose the right operation for your specific needs.
Lumbar Fusion
Lumbar fusion is a type of spinal surgery used to treat pain caused by motion between vertebrae in the spine. This procedure involves using a bone graft to help stabilize the segment of the spine causing the pain to occur.
To perform this procedure your surgeon will make an incision in the skin and typically remove a piece of the hip bone to use as the graft. Using the same incision, the surgeon will then place the bone graft between the intended vertebrae. The graft will be fastened in place using screws and rods. Once the fusion is complete, surgical instruments are removed and the incision is closed up.
The operation for this form of spinal fusion will usually last 4 to 8 hours. With advancements to minimally invasive surgery, people are now able to return home the same day as their procedure. Our goal is to get you back in action as soon as possible.
It is important to note that this is not the only approach to spinal fusion. Other procedures used to perform a lumbar spinal fusion include:
Anterior/posterior fusion
Posterolateral gutter fusion
ALIF
PLIF
XLIF
TLIF
Lumbar Laminectomy
Lumbar laminectomy is used to treat pain, numbness, weakness, or tingling being caused by spinal stenosis or a narrowing of the spinal canal. The procedure involves removing a small portion of the vertebrae to open up more room in the spine for the nerves and decrease pressure.
To perform a lumbar laminectomy, your surgeon will make a small incision in the back and insert small surgical instruments. Using the instruments, your surgeon will locate the targeted disc, pulling back any muscles, ligaments, and tissue in the way and remove the laminae, relieving spinal pressure. Once complete, the muscles, ligaments, and tissue are replaced and the incision is closed.
Like lumbar fusion, lumbar laminectomy is an inpatient procedure. The operation typically lasts for around 2 to 3 hours. Florida Surgery Consultants can have patients back home the same day as their procedure.
Lumbar Discectomy
Lumbar discectomy is a surgical procedure used to treat a herniated disc or bulging disc. A herniated or bulging disc occurs when a disc ruptures and begins to push out, putting pressure on nerves in the spine. This can lead to numbness, pain, tingling, or weakness in the back or legs. This form of surgery involves removing a portion or all of the ruptured disc to ease pressure on the nerves and reduce pain.
As with laminectomy, lumbar discectomy is performed by making a small incision in the back of the patient above the damaged disc. Once the incision is made, your surgeon will insert an operating microscope and small surgical instruments. Using these instruments, your surgeon will gently cut away a portion of the herniated disc tissue, or the whole disc in severe cases, creating enough space for the spinal nerve while maintaining the integrity of the disc and spine.
After the procedure has been completed, your surgeon will remove the instrument and close up the incision. A lumbar discectomy is a relatively fast surgery, lasting around 1 to 3 hours. You should expect to be discharged from our outpatient surgery center within 24 hours of the procedure.
Discuss the Goals of the Surgery With Your Surgeon
When considering undergoing any surgery, let alone a serious surgery such as spinal surgery, it is crucial that you take an active role in the process and learn all you can about surgery you are about to receive. Make sure you take the time to research your procedure well in advance. You want to have a good understanding of what to expect leading up to the surgery and following the surgery.
A big part of gaining a comprehensive understanding of your surgery is discussing the procedure with your surgeon. You will want to go into detail with your surgeon about what the goals for surgery are. Your surgeon will be able to tell you what to expect from surgery and the potential benefits the surgery can have for you.
Schedule Your Consultation Today
Call us today at 833-50-PAINFREE to schedule a consultation or click below to schedule online.
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Pre Surgery Preparation Tips
Remember that the best way to ensure a successful outcome for surgery is to be proactive in your preparation before and recovery after surgery. In the weeks or months leading up to your procedure there are several things you can do to help you get ready for the day of operation and prepare you for the best possible outcome.
Nicotine in the body can cause issues with bone fusion and healing. This can lead to complications in the recovery process following surgery. This is why it is important to avoid any form of nicotine leading up to your procedure. If you are having issues with smoking cessation prior to surgery, talk with your physician about developing a plan for effectively quitting smoking for at least the month leading up to surgery.
Obtain the Required Medical Clearance
Possibly the most important thing before being ready to undergo surgery is to obtain the proper medical clearance prior to your surgery. Spinal surgery can be a stressful event on the body and not everyone who could benefit from surgery will be an acceptable candidate.
First you will need to submit your medical history and undergo a physical examination along with any other required medical tests. For patients with heart disease, diabetes, or other diseases, your surgeon will need written clearance from any specialists prior to surgery.
Depending on your medical history, allergies, or age, you may need to speak with an anesthesiologist prior to surgery. Any patients suffering from depression or anxiety should discuss this with your surgeon and physician leading up to surgery. Also, be sure to notify your regular physician and any pain specialists you may have about your upcoming procedure.
Get the Required Medical Testing
It is very important that you complete any required medical testing within 30 days of your scheduled surgery date. Medical tests to determine the validity of your candidacy for surgery include:
EKG
Chest X-Ray
CBC with differential, Full chemistry,
ESR, PT/PTT
Urinalysis with culture
Type and screen testing
Stress test for patients with a history of cardiac disease
Recommendations For Medications Prior to Surgery
It is extremely important to discuss any medications or supplements you are currently taking with your surgeon before surgery. You may be required to stop taking certain medications or supplements a couple of weeks or a month prior to the procedure date.
Any nonsteroidal anti-inflammatories, including Ibuprofen, Advil, Aleve, and Motrin, should be stopped at least 7 to 10 days before surgery. Any blood thinners should also be stopped 7 to 10 days before your surgery. If you take any herbal supplements or certain vitamins, such as Ginseng, St. John’s Wart, Vitamin C, or Vitamin E, these should also be stopped 7 to 10 days out from surgery.
On the morning of surgery be sure to avoid taking any diuretics or ACE/ARB medications. If you have any questions or concerns about what medications or supplements to avoid in preparation for your surgery, be sure to ask your surgeon.
Review This Pre Surgery Checklist
Once you have been medically cleared for surgery and have taken the proper steps steps to prepare yourself and your body for surgery it is time to go through your pre surgery checklist.
Review and understand the physical restrictions and recovery exercises to adhere to following surgery. This should include no bending, twisting, or lifting objects greater than 5 pounds.
If you live alone, ask a friend or family member to check on you occasionally following surgery. Depending on the type of surgery you undergo, you may need assistance for a while after your operation.
Arrange to stay in a hotel room or with a friend the night before your surgery if you live out of town. Surgery typically starts early in the morning, so patients should arrive at the surgery center 2 hours before their procedure.
You will not be able to drive yourself home after the surgery, so make sure to have a friend or family member ready to drive you to the outpatient surgery center and be able to pick you up once you are discharged.
Make sure you have received instructions from your surgeon on what medications you will need to stop taking before your surgery and how many days before surgery you will need to stop taking them.
Make sure you have read through your surgery guidelines in advance and ask your surgeon if you have any questions.
You will not be able to eat or drink anything after midnight the night before your procedure.
Recommend not bringing any valuables such as jewelry when you come in your spinal surgery. We also recommend wearing comfortable clothing and comfortable shoes.
What To Know for the Day of Spinal Surgery
When the day of surgery has finally arrived there are a few more tips you can follow to help make the process as seamless as possible and put your mind at ease. Remember that you will need to arrive at least 2 hours before your surgery is scheduled. Once you have arrived at the outpatient surgery center, report to the pre-op area.
What To Expect During Pre-Op
After you have been checked in, a member from the surgical team will meet with you to confirm the procedure you are there for. Next you will be given a brief exam and have your vital signs taken. You will then be given surgical consent forms to read through and sign. This is a great time to ask any questions about the surgery that you have not been able to ask before.
Once you are cleared and the consent forms have been signed, the anesthesiologist will come out to speak with you. They will ask you a few questions, feel free to ask any in return, and then escort you to the operating room. After you have been made comfortable, the anesthesiologist will begin an IV drip to put you under and put TED stockings on your legs to help prevent blood clotting and swelling in the legs. These stockings will need to be worn for the duration of your stay and for several days after you are discharged.
What Should You Wear & Bring With You To The Outpatient Surgery Center
When preparing for the day of surgery you want to be wearing comfortable loose fitting clothing, preferably pants with an elastic waistband. You will also want to wear comfortable shoes. Shoes that do not require laces and can be easily slipped on and off are ideal as they do not require you to bend over.
Since most spinal surgeries require at least one overnight stay, be sure to pack toiletries, pajamas, and a cell phone charger. Do not forget to pack glasses, dentures, or hearing aids if you require them. Remember, we do not recommend bringing any valuables such as earrings, necklaces, or rings when coming in for your spinal surgery.
Tips for the Night Before Surgery
As you are getting ready the night before surgery, remember that you will be asked not to eat or drink anything after midnight the night before surgery. If your surgery is scheduled to take place very early in the morning you may be asked not to consume any food or beverages after 9pm the night before.
It is always a good idea to double check your pre surgery checklist the night before and make sure you have everything you need for your time at the surgery center. Fortunately, patients that work with Florida Surgery Consultants normally are back home the same day as their minimally invasive surgery.
Make sure you have stopped taking any medications your surgeon has advised you to stop in the days before your procedure. A member of the surgical team should contact you the evening before your operation to confirm your surgery details and make sure you are ready to check in the next day.
Recommendations For Medications Prior to Surgery
Remember that you will need to arrive at the surgery center at least 2 hours before your scheduled operation. This gives the surgical team time to properly check you in and make sure you are ready for surgery.
Once you are admitted, a member of the surgical team will review your medical history, your surgeon’s notes, and make sure that you have followed all pre surgery instructions you have been given. Next, a brief physical exam will be performed and vital signs will be checked.
Finally, an IV (intravenous line) will be started and any pre surgery drugs, such as anesthesia, will be administered. When the team has determined you are ready, you will be taken into the operating room (OR) where your surgery can be performed. You may be put to sleep in the OR or in the pre-op room. During surgery, your anesthesiologist will continually monitor your vital signs.
What To Expect After Spinal Surgery
You have checked into the outpatient surgical center, consent forms have been signed, you have been brought into the OR, and surgery has been successfully performed, but what happens to you next?
Where Are You Taken After Surgery?
Once the operation is completed, you will be taken to a recovery room where members of the medical staff can closely monitor your health and periodically check your vitals. You should awaken while you are in the recovery room and you will be kept here until you are stable to ensure there are no post surgery complications.
After you have been deemed stable, you will be transferred to your patient room. You will remain here until you are discharged from the surgical center. In your patient room, members of the surgical staff will continue to check your vital signs periodically and help manage any pain you are experiencing from the procedure.
Who Will You Meet With After Surgery?
For those recovering from traditional surgeries at the surgical center, they may be visited by a social worker and home care coordinator. These people can help them take care of any special needs they have at home during their recovery stay. Fortunately, this isn’t something people need to worry about when they choose Florida Surgery Consultants. We’re capable of performing a diverse set of minimally invasive surgeries that don’t require extended recovery stays. Most people are back home the very same day.
For patients who are religious and would like to speak to members of their faith, chaplains, priests, rabbis, or other ministers of faith can be made available.
You will also be visited by occupational and physical therapists while recovering from your surgery. They will help you begin your physical recovery with exercises and assistance to regain your strength and balance.
Immediate Pain Management & Dietary Advice
An IV with pain medication will be started right away following surgery. While you are receiving pain medication through an IV, it will be administered using a patient-controlled analgesia (PCA) pump. This allows you to control the amount of pain medication you are getting.The PCA pump will only be used for a brief time. Once the PCA pump is stopped, the medical staff will give your oral pain medication to help you manage your pain.
Immediately following your operation, you will only be given clear liquids to consume. After you have shown to be handling clear liquids well, the medical staff will begin to gradually advance your diet until you are able to consume regular meals again.
Exercises You Can Do Immediately After Spinal Surgery
Your road to recovery begins as soon as you wake up following your procedure. You will be advised to avoid any twisting or bending at the waist while you are recovering in the surgical center. For some people a brace may be needed, however this is not always the case.
As mentioned above you will be visited by a physical therapist while you are recovering in the surgical center. Your physical therapist will begin teaching you exercises to help you build up strength and balance as you recover. They will teach you how to properly get in and out of bed or a chair as to avoid injury.
Your physical therapist will also provide you with any necessary equipment you may need such as a walker or a reacher. Once your physical therapist has determined you are ready, they will help you start to walk again and then help you tackle walking up and down stairs.
If you neck and back problems that can’t be addressed through more conventional methods, we can help! Schedule a consultation with Florida Surgery Consultants and we’ll get you back on track.
We operate 7 outpatient surgical centers across Central Florida. You can find a neurosurgeon near you.
Recommendations For Recovering At Home After Spinal Surgery
The type of surgical procedure you are undergoing will determine how long you have to stay in the surgical center to recover. However, recovery does not end when you are released to return home. Here are some recommendations for ensuring a smooth and fast recovery at home following your surgery.
Are You Prescribed Pain Medication?
You will most likely be prescribed pain medications after you are released from the surgical center. It is important to note that narcotic pain medication tends to cause constipation. Make sure to drink plenty of liquids while you are taking pain medication. You should also increase the amount of fiber in your diet and consider taking stool softeners to help improve your bowel movements.
If you have not had a bowel movement in over two days, you should employ a laxative to help you avoid any complications from constipation.
Narcotic pain medications can often be addictive. Because of this, do not use pain medication unless necessary and begin to wean yourself off any dependency on pain medications shortly after surgery. It is recommended that you try to be completely off your pain medication within three months of surgery. If you still need pain medications after 3 months, you can be connected with a pain management specialist to help advise you.
Restricted Medications for Lumbar Fusion Patients
For patients receiving a lumbar fusion surgery, they will be asked to avoid taking any non-steroidal antiinflammatory medications. The amount of time they are told to avoid these medications can depend on the patient and the situation. However, it is typically recommended to avoid these medications for up to 3 months after surgery.
Medications that should be avoided following lumbar fusion include, but are not limited to:
Ibuprofen (Advil, Motrin)
Naprosyn (Aleve)
Celebrex
Mobic (Meloxicam)
Indocin
Voltaren
Aspirin
Lodine
Tips For Your Surgical Incision
To close up the incisions made during surgery your surgeon will typically employ sutures, dissolvable sutures and steri-strips, or staples. For patients who receive sutures or staples they will need to be taken out around 10 to 14 days after your procedure.
Patients who qualify to receive in-home care can speak with the home coordinator to arrange for a home care nurse to come and remove the sutures or staples. However, if you do not qualify for home care, be sure to schedule an appointment with your surgeon’s office or your primary care physician to have your sutures or staples removed.
Immediately after the spinal surgery procedure, the medical staff will apply a dry gauze dressing to the incision area to help with draining. The dressing must stay on the incision until the incision is no longer draining. Once draining has stopped, the dressing can be removed and the incision can be exposed to open air.
When you have returned home from the surgery center it is important not to apply any ointments, lotions, or oils to the incision, but allow it to heal on its own. Also, remember not to soak your incision in water. This means no baths or swimming. Quick showers are acceptable, but speak with your surgeon for specific instructions.
If you experience any bleeding, an increase or change in draining, increased redness and swelling, or fevers, do not hesitate to call your surgeon or get taken to the emergency room.
Can You Have Sex?
Before resuming any sexual activity, check with your surgeon to make sure it is safe for you. However, you should be able to resume sexual activity when you feel ready after returning home. Remember to listen to your body and do not continue if sex becomes painful at any time. You may find that some positions are easier and more comfortable while you are recovering.
Can You Drive?
It can be very difficult to rely on others for rides and you will naturally want to get back to driving as soon as possible following your surgery. However, you should not operate any motor vehicles while still taking narcotic pain medication. Narcotics can slow reflex time and alter judgment, making it dangerous to get behind the wheel.
Once you can manage your pain without narcotics, speak with your surgeon and if you are cleared to drive, you can return to driving whenever you are ready. Start with only taking short trips. If you have to take a long car drive, stop every 30 to 45 min to get out and stretch.
When can You Return to Work?
Recovery from spinal surgery requires a lot of your focus and energy and can leave you feeling drained in the weeks following your operation. To be safe, it is best to inform your employer prior to surgery that you may be out for around 8 to 12 weeks. However, you may return to work earlier if you feel sufficiently recovered and able to work.
Additional Lifestyle Tips for Spinal Surgery Recovery
Beyond following your surgeon’s instructions and physical therapist’s exercises for recovery there are additional lifestyle choices you can make to help aid your recovery process. These tips can help you recover faster and deal with pain more efficiently over the course of your recovery.
Tips for Physical Activity & Lifting
It is important to remember to try and avoid twisting or bending at the waist as much as possible for the first 6 weeks you are recovering at home. During this time one of the best physical activities you can perform to help improve strength and energy is walking. Begin with very short works and work your way up to walking for 30 minutes, twice a day.
As you are recovering from your spinal surgery, it is important to try and maintain good posture keeping your spine in the neutral position. Avoid lifting any objects heavier than 5 pounds. As your recovery progresses you can begin to gradually engage in more strenuous physical activity and lift heavier objects. However, if any activity or lifting begins to become painful, make sure to stop right away.
To avoid potential injury while lifting objects, remember to use proper lifting form. Begin by moving close to the object you are lifting, using a wide stance, with feet firmly planted. Next bend at the knees, keeping your back straight. Use a firm grip to pull the object close to your body and begin to rise by straightening your knees slowly, pushing through your heels. Once upright, use your feet to turn instead of twisting your body.
Sleeping After Spinal Surgery
It is important to note that you will probably be very tired in the first few weeks following surgery. The combination of narcotic pain medications and the stress from spinal surgery will exhaust your body, leading you to rest and sleep frequently.
It is best to try and maintain a neutral spine position while you are sleeping. This will make you the most comfortable and help you avoid pain. The best positions to sleep in while you are recovering from surgery are to either lay flat on your back with your knees bent and a pillow under your legs, or to lay on your side with your knees bent and a pillow between your legs, keeping your back straight.
Try to avoid sleeping on your stomach or with your arms above your head. This can cause stress to your shoulders and spine and lead to discomfort. Also, if you need to roll over or change positions while sleeping, use the log roll method. To log roll, keep your back straight and do not twist your spine as you roll from side to side.
You also want to avoid using your back to sit up when you are getting out of bed. Instead, log roll onto your side and use your arm to push yourself up into a sitting position. Then, keeping your back straight, use your legs to stand up.
Sitting After Spinal Surgery
When sitting following spinal surgery, it is very important to maintain good posture. Slouching or sitting lower in your chair can put stress on your spine and cause pain and discomfort. Make sure to keep your back straight, shoulders back, and chest up, keeping your ears, shoulders and hips aligned.
It is best to try and find a chair that provides good lumbar support to sit in while you are recovering at home. In the weeks following surgery avoid sitting in soft chairs and couches. Be sure to stand up and stretch every 30 to 45 minutes if you are sitting for long periods of time.
What To Expect At Your Follow Up Appointment
Expect to schedule a follow-up appointment with your surgeon 6 weeks after your procedure. This appointment is to check and see how your recovery is coming along and to make sure that your spine is healing properly. In order to check the progress of your spine x-rays will need to be taken during this appointment.
You may also be given physical therapy exercises to begin doing at home to help improve strength and mobility in your back. Depending on how well your recovery is progressing you may be prescribed physical therapy sessions to help aid your recovery.
When considering undergoing any surgery, let alone a serious surgery such as spinal surgery, it is crucial that you take an active role in the process and learn all you can about surgery you are about to receive. Make sure you take the time to research your procedure well in advance. You want to have a good understanding of what to expect leading up to the surgery and following the surgery.
