Surgery Overview

Spinal surgeries are done for a variety of different reasons. The aim of the spinal surgery is to remove whatever is irritating or compressing the spinal nerves in order to alleviate symptoms. Your surgeon will decide which procedure or combination of procedures will work best for you in relieving your symptoms.

Your surgeon may perform a laminotomy/laminectomy by removing part of the bony vertebra or may perform a discectomy by removing part of the damged disc between the vertebra. The surgeon might also perform a combination of both procedures depending on your symptoms and the cause of the problem. The type of surgery you will have is most often decided before the surgery day, but sometimes revisions to the plan may be necessary.

A laminotomy is performed when the surgeon only needs acess to a small segment of the damaged disc. It involves removing just a small portion of the lamina. A laminectomy is performed by removing the entire lamina which releases pressure when the disc bulges. Removal of the entire lamina allows greater access to the disc. When the surgeon performs a discectomy they form a small opening in the torn portion of the outer rings of the disc. The surgeon then removes a small portion of the nucleus of the disc which releases pressure on the nerve. Spinal surgery usually takes from 1 to 5 hours.

Preparing for Surgery

Spinal surgery is a major surgery, so pre-op preparation must begin once you have been told by your surgeon that surgery is necessary. Shortly thereafter or maybe even the same day, a screening interview with the neurosurgery nurse practitioner (NP) will be performed. This will be done either by telephone or in the nurse practitioner’s office. The NP will screen you for risks for post-surgical complications and consult the appropriate specialists (e.g. a heart or lung doctor) if necessary. The NP will also ensure that all of the required labs and testing are complete and within normal limits.

About one to two weeks before surgery, you should visit your family doctor for clearance for surgery and any pre-op testing or lab draws. If you are taking any medications (Coumadin or blood thinners such as Plavix), find out when it is safe to discontinue them prior to surgery. If you have seen your medical doctor recently, he/she should inform the surgeon that you are medically cleared for the operation. If you see a medical specialist, have him/her also inform the surgeon that you are medically fit for surgery. If you do not have a medical doctor, the surgeon will refer you to a medical doctor prior to surgery. You must be cleared by a medical doctor before any surgical measures can be taken. All dental work should also be completed before surgery.

If you are overweight, you should try to lose weight before your operation. The less you weigh the less stress on your spine. Although it is important to weigh less, avoid dieting before surgery. You should try to maintain a well balanced diet. Your body should be well nourished. Your doctor may also recommend a multivitamin with iron. If you are a smoker, try to reduce or quit smoking before your surgery. Smoking increases the risk for respiratory problems after the surgery and retards the body’s healing process.

Post Operative Care

You will be kept as comfortable as possible. Pain medicine is custom tailored to every patient’s needs. With spinal surgery you may stay in the hospital a few days.

Measures will be taken to assist in clearing your lungs of secretions collected during surgery. Blood draws will also be done for days after surgery to monitor your blood count. It is very important to eat the balanced diet provided by the hospital to help with healing your incision. It is also important to drink two to three quarts of liquids every day to decrease the possibility of fever, urinary tract infection, or constipation.

Patients are encouraged to walk immediately after surgery. Physical therapists and occupational therapists will work with you to learn to walk safely, work on range of motion, and other ways to protect your spine. You may be given a neck collar or back brace to wear as your surgeon instructs. You may wear special stockings or boots to prevent blood clots in your legs.

It is important during your recovery time to use pain medication as prescribed by your surgeon, see your surgeon on a regular basis for check-ups, and to get moving. Exercise can help in your recovery, but not in excess. Be sure to ask your surgeon what activities to avoid and when you can return to normal activities.

It is very important to have someone at home to help you once you are discharged. Have assistance set up before coming in for surgery. This is your responsibility.