HF 7025

Home Care Instructions after Thoracic and Lumbar Spine Fusion Surgery

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.

Activity/Limits

You should slowly increase your activity. In most cases, common sense will tell you when you are doing too much. On the other hand, doing too little can delay the return of your strength and stamina.

  • Climbing stairs is okay to do right after surgery.

  • Begin walking 3 times a day once you return home. Increase the distance as you can.

  • You may walk anywhere your footing is safe; stairs, treadmills, walking tracks, or inclines.

  • No sports, aerobic or cardio activities until seen at your follow up visit.

  • Follow the activity limits below until your 4-6-week postop visit with your surgeon:

    • No bending or twisting from the waist.

    • No lifting greater than 10 pounds.

    • Avoid strenuous and jarring activities.

Incision Care

Proper incision care helps to decrease the risk of infection. The incision is closed with dissolvable sutures. These should dissolve in 2-3 weeks. Do not pick at these or pull them out prematurely.

  • Always practice good handwashing before caring for your incision.

  • Surgical dressing should remain in place for 5 days after surgery.

  • After the first 5 days, dressing may be removed.

  • If no drainage is present, the incision may be left uncovered.

  • Some redness and swelling around the incision is normal.

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

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

Once able to remove the dressing, check incision for:

  • Redness

  • Swelling

  • Drainage

  • Warmth

Driving

  • Do not drive for 2 weeks or while taking narcotic pain medicine.

  • Do not drive until your reflexes return to normal and you feel safe to do so.

Sexual Activity

  • No sex for 2 weeks.

  • After 2 weeks, you may resume sex if comfortable.

Sleeping

  • Sleep on either your back or side.

  • You may use pillows for support.

  • Place pillows behind your knees when lying on your back.

  • Place pillows behind your back and between your legs when lying on your side.

Smoking

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

Compression Stockings

If you are given compression stockings in the hospital, please keep wearing these until you are walking three times a day. This is most often 2-3 days after leaving the hospital. You should sleep with them on. Make sure the fabric does not bunch up, it should be smooth against your skin. If you notice swelling to your legs, please elevate and put on compression stockings. If the swelling does not improve, please call the clinic to discuss.

Pain Management

During the healing phase, it is common to have some pain, numbness, tingling and weakness in your neck and arms. Please call the Spine Clinic if there are big changes in your symptoms since leaving the hospital.

Ways to decrease pain after surgery include:

  • Ice the incision area for 15-20 minutes several times a day or after increased activity. Be sure to use a towel as a barrier between the ice pack and skin to avoid harm to skin.

  • Heat compress with a barrier 72 hours after surgery. May use alone or alternate with ice.

  • Decrease overall activity for 48-72 hours. Advance activity as tolerated.

  • Take narcotic medicine as prescribed by your doctor. If you feel the medicine is not decreasing your pain, please contact the clinic to discuss.

  • Do not increase your narcotic pain medicine without talking to your doctor first. Doing so will cause you to run out of medicine early and will not guarantee an early refill.

  • Do not use non-steroidal anti-inflammatory drugs (NSAIDS) like ibuprofen, Aleve, aspirin, Diclofenac, etc. for ____ days after surgery.

  • Start Tylenol (acetaminophen) right away after surgery. Do not take more than 3000mg within 24-hours.

Refills

The goal is to taper you off all narcotic pain medicine 4-6 weeks after surgery. If you need a refill, please call the clinic. Please allow at least 2 full business days for refill requests. Refills cannot be provided after hours or on the weekends. Call 2-3 business days before you need the refill. Please provide the pharmacy where you want to pick up a refill.

If these medicines were used before surgery, and you feel you will need to continue taking them, talk to the prescribing provider to continue use of opioids. We do not prescribe opioids beyond 6 weeks after surgery.

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).

When to Call

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

  • 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.

  • Redness, warmth, swelling, or pain in your calf.

  • A temperature above 100.5 F for 24 hours.

  • A constant headache that changes between sitting/standing and laying down.

  • New chest pain or new problems breathing.

  • New weakness that was not present when leaving the hospital or before surgery.

  • Inability to urinate or feeling like you are not urinating fully.

  • Loss of bladder or bowel control.

Return to Work

The length of time off work will depend on your postop symptoms and type of work you do. If you plan to go back to work before your first postop visit you will have restrictions. Please call to talk about this with your doctor or nurse.

Future Clinic Visits

A 6-week postop visit will be scheduled to check healing and symptoms. All other clinic visits will be determined by your doctor.

Who to Call

If you have questions or concerns, please call the Spine Clinic Monday through Friday between 8:00 AM and 5:00 PM at (608) 265-3207.

Toll-free 1-800-323-8942

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