Spinal fusions are done for a variety of different reasons. Fusions are basically done to eliminate movement in the spine. Movement in certain areas of the spine can be detrimental. Discomfort and pain can be caused in your neck and back from repetitive motion over painful discs or other structures.
During a spinal fusion, your surgeon locks together (fuses) some of the bones in your spine. This fusion prevents further deformity from occurring in the spine by fusing the vertebrae together and eliminating motion in the spine. Following spinal fusion surgery, your neck or back will not be as flexible as it once was. You might however feel more flexible after surgery because the pain has been eliminated.
There are two types of spinal fusion surgery, and they depend on where your pain is located. Cervical fusion takes place if the pain is located in the neck and lumbar fusion if pain is located in the lower back. Fusion surgery can be done from the front (anterior) of the body or the back (posterior). Your surgeon will decide which is applies to you.
Preparing for Surgery
Spinal Fusion 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 cervical fusion you may go home the day after surgery. With lumbar fusion you may be in the hospital for 2 to 7 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.
Recovery from spinal fusion of the neck can take around 3 months. For lower back fusion, recovery can take 6 months to a year. 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.
- Avoid tub baths, swimming, and hot tubs until released by the surgeon; ask your surgeon if you are allowed to shower
- Avoid jumping- even at low surfaces
- Avoid jogging or high impact sports
- Do not bend over from the waist to pick up anything from the floor
- When sitting use a straight chair with arms to aid your rising to a standing position
- Be careful in slippery, cluttered, or uneven areas so that you don’t fall
- Take antibiotics before dental or any medical procedure
- See your doctor to treat all suspected bladder infections or other infections
- Look for signs of infection in your incision including pain, redness, swelling, or increased warmth
- Avoid pushing, pulling, or twisting and heavy lifting
NOTE: Refer to your physician or therapists for precautions specific to you.