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HF 4499

Home Care After Cervical Spinal Fusion (Anterior and Posterior)

Surgery Date: _______________________

Doctor: ______________________________

This handout will review the care you need to follow once you are home. If you have any questions or concerns, please ask your nurse or doctor. Our staff is here to help you. If you have questions after you are at home, please call the numbers at the end of this handout.

Patients with a Hard Collar

For the first 6 weeks, you must always wear the hard collar. You must wear the collar even when you shower and sleep. You may be given a soft collar when you return for your first clinic visit.

Bathing with a Hard Collar

You may shower after 5 days with the hard collar on and padding removed. To remove and apply padding, follow the instructions you were shown at your fitting. When done bathing, remove the collar and place a clean dressing over the incision if needed. Put the hard collar back on with clean and dry pads. 

Patients with a Soft Collar

For the first 2 weeks, use the collar for comfort as needed or when out in public, sleeping or driving. The soft collar does not need to be worn during bathing.

All Patients

No sports except for walking or using an exercise bike, if allowed. No impact aerobics. Walking is your form of exercise until your doctor gives you the okay to do more. There are no limits on stair climbing or sitting. Use your comfort level as a guide for the amount of time you sit or climb stairs. Most people find they need to change positions after 60 minutes of sitting. 

Smoking

We strongly suggest you quit smoking, avoid nicotine products, and second-hand smoke. Smoking will delay bone healing. It is best not to smoke for at least 4-6 months after surgery.

Compression Stockings (TEDS)

To improve blood flow and decrease the risk of getting a blood clot, you need to wear elastic stockings (TEDS) until you are walking at least 3 times a day. Remove the TEDS 2 times each day for one hour. You should sleep with them on. You may wash the TEDS with soap and water. Let air dry.

Effect on Your Throat 

If you have had an anterior cervical fusion, it is common to have a sore throat or hoarse voice for a few weeks after surgery. You may also feel a “catching” sensation in your throat. You may find lozenges and eating soft foods helps. 

Sleeping

If you have a hard collar, sleep on your back or side with the collar on for the first 6 weeks. If you have a soft collar, wear the collar when sleeping the first 2 weeks. Place a cushion under the back or side of your neck for comfort.

Limits

  • No driving while taking narcotic pain medicine and your reflexes return to normal.

  • No lifting more than 10 lbs (about 1 gallon of milk) for the first 6 weeks.

  • No overhead reaching.

  • Limit head and neck movement.

Sex

After 2 weeks, you may resume sex if comfortable.

Incision Care 

Proper care of the incision helps to prevent infection. 

  • Keep the incision clean and dry. 

  • After 5 days, change the dressing every other day or as needed. 

  • After 5 days, check the incision daily to be sure it is clean and dry.

  • Check for redness, swelling or drainage. Some redness and swelling are normal. 

  • A small amount of clear or slightly blood tinged drainage from the incision is normal. 

  • Do not wash directly over the incision. Wash around the incision gently with soap and water and then let air dry. 

  • Do not use any creams, lotions, ointments, or alcohol near or on the incision. 

Anterior Cervical Fusion 

The incision is closed with sutures that dissolve under the skin and covered with steri-strips (small pieces of tape) on the skin. These will slowly peel off as they get wet when you shower. You may gently remove them after 10 days.

Posterior Cervical Fusion 

The incision is closed with staples or sutures and will be removed in 2 weeks at the Spine Clinic. Keep a clean dressing over the incision.

Pain 

It is common to have some pain, numbness, tingling, and weakness in your neck or arms as you heal. If you have an increase in pain once you return home, try these options to lower the pain:

  • Ice the neck for 15-20 minutes each hour for 4 hours. Do not put ice directly on the skin. Use a pre-made ice pack or put ice in a plastic bag. Wrap the ice pack or bag in a towel.

  • Do not sit more than 15 to 30 minutes at a time for the next 48 hours.

  • Reduce your activity for the next 48 hours (such as walking). 

You may also need to use pain medicine. If needed, take it as prescribed by your doctor. 

  • Narcotics: Do not increase the prescribed dose without checking with your doctor or nurse. 

  • Tylenol® (acetaminophen): You may take up to 3000 milligrams per day. Percocet® and Vicodin® also contain Tylenol®. If you have liver disease, do not take Tylenol® without checking with your doctor first. 

  • Do not take non-steroidal anti-inflammatory drugs (NSAIDs) (ibuprofen®, Motrin®, Advil®, Aleve®, etc.) for 3 months. These medicines delay bone healing. 

  • If you are not sure about a medicine, please call the Spine Clinic. 

Constipation

Constipation is common after Surgery. Surgery, narcotic pain medicine, decreased activity level, and a change in your diet can cause constipation. Please see Health Facts for You #4843: Constipation from Opioids (Narcotics). 

Refills

The Spine Clinic staff will help you balance pain medicine, manage your pain and activity. 

If you need a refill on your pain medicine, call the Spine Clinic. Please call when you have at least a 3 to 4 day supply left of your medicine. Be ready to give the name, address, and phone number of the drugstore where you want to pick up a refill. You will need to speak with nursing staff to discuss current symptoms and the amount of medicines being used.

Future Clinic Visits

The nursing staff will help you schedule your first clinic visit in 2 weeks if you have staples or sutures. For all other patients, your first clinic visit will be in 6 weeks. All other clinic visits will be as needed.

Return to Work

Your return to work will depend on your recovery and the type of work you do. Talk to your doctor before you return to work.

When to Call 

  • Increased pain, swelling, or redness in or around the incision site.

  • Sudden increase in pain or pain not relieved by medicine.

  • Increased drainage, change in the color of drainage, or any odor from the incision. You will need to describe what the drainage looks like, how it smells, and how much there is.

  • A fever above 100.5ºF or 38.1°C for 24 hours.

  • A “new” chest pain or “new” problem with breathing.

  • Redness, warmth, or tenderness in the back of the calf of your leg(s).

  • A headache that is different when sitting or lying.

If you have any trouble breathing, cannot swallow, or have any major voice changes, call 911. 

Who to Call

If you have questions or concerns, please call the Spine Clinic. Call (608) 265-3207 Monday-Friday between 8 am and 5 pm.

After hours, call the paging operator at (608) 262-0486. Ask for the “orthopedic resident on call.” Leave your name and phone number with the area code. The doctor will call you back.

The toll-free number is: 1-800-323-8942.

If you are a patient receiving care at UnityPoint – Meriter, Swedish American or a health system outside of UW Health, please use the phone numbers provided in your discharge instructions for any questions or concerns.