Preparing for any kind of surgery can be particularly nerve-racking, not to mention spinal surgery. However, if you or a loved one is in need of lumbar spinal fusion, knowing what to expect before, during, and after surgery can help set your mind at ease and prepare you for the best possible chances of a successful outcome.
The neurosurgeons and staff at Florida Surgery Consultants have years of experience guiding patients through the surgery process and aiding them on a swift recovery. If you have any questions about how to prepare for your procedure, speak with a neurosurgeon today at (888) 411-6824.
What is a Lumbar Spinal Fusion?
Lumbar spinal fusion is a surgical procedure used to treat back, leg, or arm pain caused by vertebrae in the spine rubbing against one another abnormally. As the name suggests, the purpose of a lumbar fusion is to fuse together two or more of the problematic vertebrae, stabilizing and aligning the spine. This helps to reduce pressure on the spinal column and nerves, alleviating pain, and preventing further damage.
A lumbar spinal fusion can be performed in a number of ways depending on the vertebrae that need to be fused and the specific needs of the patient. To perform a lumbar spine fusion, two or more vertebrae must be fused together in order to prevent motion at an unstable segment. A one-level involves fusing two vertebrae together. A two-level fusion consists of fusing three vertebrae together and so on.
Vertebrae are fused together using a bone graft. There are a number of bone grafts that can be used to fuse the vertebrae together including:
- Allowing the body’s natural healing process to fuse the bones
- Using bone from another part of the body known as an autograft
- Using bone from a bone bank known as an allograft
- Using cage devices to set the graft
In order for the vertebrae to fuse properly, the segment of the spine where the graft is placed must be kept immobile while healing. Usually, your surgeon will use metal plates, screws, rods, or cages to prevent any movement around the fused segments. As the body naturally begins to heal, the bridge created by the bone graft fuses with the vertebrae becoming one solid segment.
How to Prepare Before Surgery
After your surgeon has determined that lumbar spinal fusion is the proper course of action for treating your spine, it is time to prepare for surgery. There are a few things you should keep in mind leading up to your procedure that will help ensure a successful outcome.
Health Screening
In order to establish that your heart and lungs are healthy enough to undergo surgery, you will need your primary care physician to perform a physical prior to your procedure. Your neurosurgeon may call for a blood test, chest X-ray, and electrocardiogram (EKG) to be performed as well.
You should also discuss any medications you are currently taking with your healthcare provider, as some medications may need to be continued or stopped prior to surgery, such as blood thinners.
Medications that thin the blood should be stopped 7-10 days before your procedure and include:
- Ibuprofen (Advil, Motrin)
- Aspirin
- Blood thinners (Coumadin, Heparin)
- Anti-inflammatories (Aleve)
- Fish oil
- Vitamin E
- Herbal supplements (gingko, glucosamine)
- Antiplatelets (Plavix, Ticlid, Lovenox)
Make sure your neurosurgeon has a complete list of your medical history prior to surgery. This should include any medications and herbal supplements you use, as well as any allergies you have and post surgeries you have undergone.
Avoid Drinking and Smoking Before Surgery
If you are a drinker or a smoker, you will need to suspend these habits before your procedure. Alcohol should be avoided at least a week before surgery and you should not resume drinking until 2 weeks after your lumbar fusion.
It is very important to quit smoking prior to surgery. This can greatly improve your odds of success. You should avoid consuming any forms of tobacco (cigarettes, cigars, chewing tobacco, e-cigarettes) at least 2 weeks before your procedure and for up to 6 weeks after.
Smoking increases the likelihood of infection and decreases blood circulation. Tobacco consumption can also inhibit bone growth, worsening your odds for a successful surgery. In fact, lumbar spinal fusion fails in 40% of smokers, compared to just 8% of non-smokers.
Prep Your Home
One of the best things you can do before your operation is to get your house ready for when you get back from the outpatient center. Preparing your house for after surgery can help make your recovery at home easier on you. Things you can do at home to improve your recovery include:
- Place any frequently used items on surfaces between hip and shoulder height to prevent you bending over or stretching to reach them.
- Think about installing temporary grab bars in the bathroom, tub, or shower.
- Place non-slip mats in the shower or tub.
- Remove or cover up any tripping hazards, such as loose wires or throw rugs.
- Find a chair that sits at knee level with a firm cushion and armrests.
- Avoid sitting in low, soft couches or chairs that are difficult to rise from.
- Purchase a raised toilet seat if your toilet sits too low.
- Stock up on foods high in fiber (fruits, vegetables, whole grain breads and cereals, beans) to help with constipation after surgery.
If you live alone, plan to have a friend or family member stay with you for the first couple of days after returning from the outpatient center. They may need to help with cooking, shopping, moving around, and caring for pets.
What to Bring to the Outpatient Center
Before you leave for the outpatient center make sure to prepare any items you need to take with you to make your stay at the outpatient center as comfortable as possible. Items you should bring with you include:
- Bathroom items
- Any personal items for relaxing (books, music, portable game device)
- A list of your medications including dosage and daily consumption times
- A list of food and medication allergies
- Comfortable, loose fitting clothing (sweat pants, t-shirts)
- Comfortable, flat, closed back shoes
- CPAP machine for those who use them
- Back brace if previously given one by your doctor
Make sure you do not bring any valuable items with you to the outpatient center, such as jewelry and wedding bands.
Night Before Surgery
The night before your operation make sure you do not consume any food or beverages past midnight, including alcoholic beverages. Make sure to take a shower with antibacterial soap and prepare freshly washed clothes to wear to the outpatient center.
Arrange to have a friend or family member drive you home once you are released, as you will not be able to drive yourself. If you have an infection, fever, or the flu the day before your operation, be sure to contact your surgeon’s office immediately.
Morning of Surgery
When getting ready the morning of your lumbar spinal fusion, be sure to shower again using antibacterial soap. Wear freshly washed, comfortable clothing. You can brush your teeth in the morning, but be sure not to eat or drink.
If you have any makeup or nail polish on, it will need to be removed before heading to the outpatient center. To allow for time to complete the necessary paperwork and pre-procedure check ups, be sure to arrive at the surgery center 2 hours prior to your scheduled procedure time.
Arriving at the Outpatient Center
As mentioned above, it is important to arrive at the outpatient center 1-2 hours before your surgery is scheduled. This will give you time to get through a preliminary check-up and finish any paperwork needed before your operation.
Once you arrive at the surgery center, the staff will check you in and take you to a room to change. You will need to remove all personal items and change into a surgery gown. Personal items include:
- Clothing
- Shoes and socks
- Contact lenses
- Dentures
- Wigs
- Jewelry
- Artificial limbs
These items can either be left with the staff or any friend or family member you brought to the surgery center with you to keep safe until you are taken to your assigned room after surgery.
Before you are taken to the operation room, an anesthesiologist will meet with you to discuss the risks involved with using a local anesthetic. Next you will be given antibiotics to combat any risk of infection and an intravenous (IV) line will be placed in your arm.
Once you are ready for surgery, you will be taken to the operation room using a stretcher. Next, anesthesia will be administered and your neurosurgeons will begin operating. This procedure will take several hours. Any friends or family at the outpatient center will be led to a waiting room where your surgeon will update them on how the operation went once it is completed.
What to Expect After Surgery
After surgery is completed, you will be taken to a recovery room where your vitals can be monitored. Once you regain consciousness and the staff have determined that you are stable, you will be taken to a patient room where you will stay until released.
People commonly experience a sore throat, dry mouth, exhaustion, and thirst immediately following surgery. The staff will do everything possible to make sure you are as comfortable as possible, but you will not be able to eat or drink straight away. However, an IV drip will be placed to help keep you hydrated and you will be allowed ice chips to help wet your mouth.
Pain and nausea is to be expected following a lumbar spinal fusion. The medical staff will monitor your symptoms and may provide pain and anti-nausea medication to help alleviate symptoms.
Depending on the type of lumbar spinal fusion, patients may be able to leave the same day as surgery while others may have to stay for 2-4 days after their procedure. During this time, your recovery will be tracked and the medical staff will determine whether you are fit to be discharged or may need to stay a little longer for further rehabilitation.
Your surgeon and staff want to make sure you will be able to move around and live independently before you are discharged. In order to be fit for release from the outpatient center, patients should be able to:
- Get in and out of bed on their own
- Shower and care for personal hygiene without assistance
- Walk down the hallway either on their own or with the help of a walker
- Go up and down stairs if needed
- Express a clear understanding of their recovery instructions
While staff will be there to provide assistance during this recovery time and guide you through physical therapy exercises to improve strength and movement, you will be encouraged to actively participate and do as much as you can on your own. Your recovery will not stop after you have been released from the outpatient center.
Returning Home After the Procedure
Once you have been discharged from the outpatient center, you will need to have someone else drive you home. Your surgeon will provide you with a detailed list of instructions to help guide you through the recovery process at home.
Depending on the needs of the patient, prescription pain medications may be provided to help deal with post-surgical pain. It is very important to follow your doctor’s explicit instructions when taking pain medications after a surgery.
Make sure you do not take any non-steroidal anti-inflammatory drugs (NSAIDs), such as Aspirin, Ibuprofen, Motrin, or Advil, without your physician’s approval. These drugs can inhibit bone growth and could cause complications for your fusion.
Important Restrictions During Recovery
While you are recovering at home from your operation, you will need to adhere to some restrictions to ensure you do not aggravate your incision or spine. Home restrictions will include:
- Do not bend, twist, or lift objects with your back for at least 2 weeks after surgery.
- Avoid lifting any objects heavier than 5 pounds for the first 2 weeks.
- Do not engage in any strenuous activities, such as intense exercise, house chores, or sex until cleared by your doctor.
- Avoid driving until cleared by your doctor.
- Try to not sit in a car as a passenger for any drives longer than 45 minutes for 2 weeks.
- Make sure to avoid any nicotine products (cigarettes, cigars, vapes, nicotine gum), as this can prevent bone growth.
- No alcohol consumption for 2 weeks following your procedure or while you are still taking narcotic medication.
Recommended Activities for Recovery
As you recover at home, make sure to stay active following the guidelines your surgeon and physical therapist have laid out for you. Try not to sit for extended periods of time. Make sure to get up and go for a 5-10 minute walk every 3-4 hours. As your strength begins to improve, begin increasing the duration of your walks.
When getting in or out of bed, use the log roll method they will teach you at the outpatient center. When laying on your back, place a pillow underneath your knees to keep your spine alignment. Similarly, place a pillow between your legs while laying on your side.
Incision Care
Once you have returned home, you will need to make sure you take good care of your incision to avoid any potential complications. Your surgeon will provide you with at-home care instructions when you are discharged.
Incision care may include:
- Avoid soaking or submerging your incision in water (baths, pools)
- Do not use any lotions or ointments on the incision
- A small amount of drainage is to be expected, but notify your surgeon immediately if there is excessive drainage, a foul odor coming from incision, or green or yellow fluid draining from incision
- Wash hands thoroughly with antibacterial soap before and after cleaning incision
- To help with pain and swelling, ice the incision 3-4 times a day for 10-15 minutes
For patients with skin glue (Dermabond) sealing the incision, showers can be resumed the day after surgery. Make sure to wash the area daily with soap and water, patting dry. If a patient has stitches, staples, or steri-strips, showers can be resumed 2 days after their procedure. Any gauze dressing must be removed before washing. Wash daily with soap and water. If the wound is still draining, replace bandage with fresh gauze dressing over the incision.
Recovery and Prevention
If you have been given a back brace to aid in the recovery process, be sure to wear your brace at all times, unless sleeping or showering. One of the best things you can do to help improve your recovery is to stay active and perform the light stretching exercises provided by your surgeon or physical therapist. This can help strengthen the area around your fusion, speeding up your recovery timeline.
In order to monitor your progress, you will need to go in for a follow-up appointment around 2 weeks after surgery. As you progress through your rehabilitation, you will most likely begin routine visits with a physical therapist. Under their careful guidance, you will be asked to perform light strength exercises and low-impact aerobics (swimming, walking). These exercises will build strength and flexibility in your back and core, helping to support your spine and prevent injury.
Unfortunately, re-injuring one’s back can be very common. The best way to avoid future back problems is to focus on preventative measures, such as:
- Practicing good posture while standing, sitting, sleeping, or moving
- Maintaining an appropriate exercise regimen
- Using proper technique while lifting
- Eating a healthy diet to avoid becoming overweight
- Avoid smoking and excessive alcohol consumption
Speak With a Neurosurgeon Today
With a procedure as serious as lumbar spinal fusion, you want to be in the hands of a neurosurgeon you can trust. The board certified surgeons at Florida Surgery Consultants have years of experience diagnosing and treating patients with all kinds of spinal injuries. Our surgeons will help guide you through the entire surgery process from start to finish to ensure you have the best treatment possible.
If your back pain has become too unbearable to live with, speak with a neurosurgeon today about a lumbar spinal fusion. Contact Florida Surgery Consultants by calling us at (888) 411-6824 or filling out the form on the right side of this page and get back to a healthy, pain free life.