Post-Op FAQs

Preoperatively, these medicines alter blood clotting, and they may cause excess bleeding during surgery. Post operatively they also affect bone healing and fusion results.

Typically, internal fixation is good, but in certain individuals with softer bone due to osteoporosis, a brace will help stabilize the spinal implants. The brace is a reminder not to move excessively. It also helps support the muscles while they are healing.

Any spinal fusion is at risk for not healing. Restriction of activity takes stress off the implants and lessens non unions. Sometimes individuals may feel like they are ready to perform certain tasks, but experience shows that, more often than not, when patients exceed our recommendations, they regret it. Driving can involve the quick and sudden movements and strength required to avoid a collision. This is not a safe activity before the first post-op visit. Also, many individuals are still taking narcotic medication and would be driving illegally.

The goal of any spinal surgery for correction of deformity or treatment of degenerative processes, involve fusing the minimum number of motion segments to stop progression of the deformity or fuse the degenerative segments. The fusion will be as long as needed to achieve these goals to minimize later surgery.

Patients are usually given a PCA (patient-controlled analgesic) pump in the hospital immediately after surgery. This allows the patient to self-medicate with controlled doses of a morphine-like drug rather than wait for a nurse to administer it. Later, patients are transitioned to oral narcotics and sent home with a prescription.

The chances of becoming addicted to narcotics after spine surgery are low. If you previously have had medication issues, then surgery and narcotics may exacerbate these issues. We make sure that our patients receive adequate pain medicine but also make sure to begin tapering them before problems exist. In some cases, a more in-depth consultation with our pain management physicians may be indicated to appropriately manage pain.

That is related to the limitation of motion allowed post op. We want to avoid excessive flexion in the lumbar spine as this may put stress or loosen the implants. Sofas and chairs that are low or soft make it difficult to get up without bending forward to shift the center of balance over the legs to get up easily. Also many sofas and recliner chairs, while appearing comfortable tend, to flex the lumbar spine as you sink into the cushion. A firm chair with arm rests is best.

No! Hospital beds are designed for the individuals taking care of the patients. They are fine for patients who are bedridden, but not for ambulatory patients. If you have a very low, full-wave water mattress or the old climb up four steps into bed "granny bed," alternate bedding would be appropriate.

Some of our older and weaker patients do go home for a short time with a walker. The goal of surgery is to position the spine in an upright posture. When patients lean forward over a walker, their spines are not upright, and the muscles that need to start strengthening to hold the upright posture are not working.

An ambulance is almost never required. We recommend a larger car, not a subcompact, for travel home. Patients should sit in the front seat and be belted. This facilitates ease of getting in and out as well as safety. Patients should never travel lying down on a mattress in the back of a van. If the trip home is more than about 75-90 minutes, we recommend that you stop every 45-60 minutes or so for a short walk-around break so as to not be so stiff on arrival home.

This depends on how extensive the surgery is and how you feel. It's fine to take small trips as long as someone else is driving. Call your nurse for advice before you take a trip of more than 30 minutes.

Physically, you have been through a rather extensive surgical reconstruction and your body is devoting lots of energy to healing. The muscles are not up to speed yet and fatigue comes quickly. Mentally, the physical exertion also takes its toll on your concentration powers. Any narcotic medication may also make concentration short and spotty at best.

The answer is easy-we choose for you. All metal implants have their inherent advantages and disadvantages. Some have slightly better strength characteristics and better imaging qualities, while others have much better characteristics to correct deformity. Any implant can adequately do the job it was designed to do, which is to hold your spine in place while the bone fuses around it. All metal implants can break if fusion is not achieved. We choose the metal implant that best suits your case.

You will be told this when you leave the hospital. Generally medications for heart, blood pressure, and other general medical conditions are fine. Non-steroidal anti-inflammatory meds like aspirin and ibuprofen will usually be held for some time.

Nutrition is an important part of healing. After surgery, your appetite may be poor for a while, but it is very important to eat as much as possible. Calorie needs for healing can double or triple the normal metabolic requirements. That is, if you normally eat 2,000 calories a day, your caloric needs might be 4,000-5,000 calories per day initially. A high-protein diet is best. Getting adequate calcium is also important. In most cases, we will make recommendations, but let your primary care doctor assume responsibility for follow-up.

Possibly, depending on how high the sensitivity is set. Our nurses can supply you with a card stating you have metal implants, but this is not a free pass through security. They will still take you aside and wand you, but generally it's less hassle than you might think.

No! Most antibiotic cream found in the medicine cabinets contains Neomycin, to which 15% of the general population is allergic. If you're allergic, a nasty dermatitis can occur, making the incision look red and irritated. No antibiotics or creams are needed.

We attempt to give you the best scar possible and use the same technique as the plastic surgeons use. Each individual scars differently, depending on the type of collagen you have, nutritional status, and other factors. On your first post-op visit, we may suggest some treatments to improve the scar, but those need to wait until the scar is mature.

For those individuals who exercise regularly, taking time off is sometimes difficult. Until the first post-op visit, we want you just to increase your general activity and walking distance. After your visit, we may allow some increased exercise.

We recommend continuing the stool softeners for several weeks until you are off the narcotics. There are several over-the-counter medicines that will help with a laxative effect, including Milk of Magnesia, Dulcolax suppositories and tablets, and, as a last resort, Magnesium Citrate, which comes in a bottle and is a much stronger stimulant.

Yes. We ask that you call early for refills. Do not wait until late Friday afternoon when you are taking your last pill. PLAN AHEAD! Refills will not be done at night or over the weekend. As time goes on, you may need a less potent medication, but often the medications we use require that a written prescription be mailed to you, so calling early is very important.

Everyone has a bad day. Generally, if you look back on your activities from the day before, you may find that you substantially increased your activities or did something you probably should not have done. If that is the case, back off your activities and work back up. If you have two bad days in a row, give us a call.

There is someone available 24 hours a day for emergencies. If you have a routine question, call during normal office hours to talk to someone on our staff.

Some spotty drainage as you knock off the scab over the incision is common. This should only be a drop or two. If you develop drainage that wets and soaks clothing, the incision should be covered, your temperature should be monitored, and you should give your nurse a call.

Generally we don't give them. We prefer that our patients to do as much walking as possible, and as you won't be driving initially, your driver can drop you off close to the door if you do go out.

Each patient's home situation is unique. Upon going home, our patients are fully independent in terms of walking, bathing and dressing themselves, and fixing a light meal. Some people are more comfortable having someone close by initially to help them, but having access to help by phone is fine. Obviously, cooking, cleaning, and grocery shopping should be done by someone else, but not necessarily a live-in person.

Science has clearly shown that smoking slows or prevents bone healing. Depending on the study you read, this effect can reduce union or fusion rates by up to 100%. Because we want the best results for our patients, it is the policy of the Emory Spine Center not to perform fusions on smokers. Nicotine patches or nicotine gums also are not acceptable. We do check urine nicotine levels to verify there have not been any exposure to cigarettes or nicotine products. Toll-free Georgia Tobacco Quit Smoking Assistance Line 1-877-270-STOP.