Preoperative:

There are no specific preoperative exercises or preparation that is needed. Since the surgical approach is through the front of the neck, I do ask that gentlemen with long beards trim them prior to surgery. Since there will be a bandage in place on the front of the neck after surgery, bring a loose fitting shirt and/or blouse to wear post-operatively.

Hospital Stay:

Most patients are discharged home the morning following their surgical procedure. The surgical procedure should take about 90 minutes. Following surgery, there will be a somewhat bulky bandage in place on the front of the neck. I do leave a small drainage tube in place, so that any bleeding that occurs overnight will be collecte. In the morning, our residents and/or our Orthopedic Midlevel Providers will change the bandage, remove the drainage tube, and apply steri-strips to the incision. All of the sutures are dissolvable sutures. A smaller bandage will be applied prior to discharge.

Post-Operative:

The dressing that you are discharged with should remain in place for 24-48 hours. You can shower, but please keep the incision and bandage dry for 4-5 days. The steri-strip can get wet after day 5, and will begin to peel off. Any steri-strips still in place by two weeks can be removed. You will be given a soft, cervical collar if you so desire. It is not necessary to wear the collar or to wear any type of brace. However, some patients may find it more comfortable to have the collar during the first week following surgery. Please request this in the hospital if you feel this would be helpful. You are free to turn and nod your head as you feel fit. Non-impact aerobic exercise can be initiated as soon as you feel comfortable. I would restrict any heavy impact activity for the first two weeks. I would not engage in contact sports for a minimum of 6 weeks.

You may find it more comfortable to eat soft foods for the first 24 to 48 hours after surgery. Some patients may experience some swallowing difficulty or may have a sore throat post-operatively. You may find that ice applied to the front of the neck can help reduce this irritation. Pain medication should be weaned down after the first week of surgery. Tylenol and NSAIDS are ok at any time.

At your first follow-up visit, you will be instructed in skin massage techniques to minimize scar formation. I will also review the radiographs with you and show you the arthroplasty position. At that visit, you will no longer have any activity restrictions. I do ask that future follow-up appointments be kept at 3 months and 1 year following surgery for routine radiographs.

Pre-Operative:

There are no specific preoperative exercises or preparation that is needed. Since the surgical approach is through the front of the neck, I do ask that gentlemen with long beards trim them prior to surgery. Since there will be a bandage in place on the front of the neck after surgery, bring a loose fitting shirt and/or blouse to wear post-operatively.

Hospital Stay:

Most patients are discharged home the morning following their surgical procedure. The surgical procedure should take about 90 minutes. Following surgery, there will be a somewhat bulky bandage in place on the front of the neck. I do leave a small drainage tube in place, so that any bleeding that occurs overnight will be collected. In the morning, our residents and/or our Orthopedic Midlevel Providers will change the bandage, remove the drainage tube, and apply steri-strips to the incision. All of the sutures are dissolvable sutures. A smaller bandage will be applied prior to discharge.

Post-Operative:

The dressing that you are discharged with should remain in place for 24-48 hours. You can shower, but please keep the incision and bandage dry for 4-5 days. The steri-strips can get wet after day 5, and will begin to peel off. Any steri-strips still in place by two weeks can be removed. You will be given a soft, cervical collar if you so desire. It is not necessary to wear the collar or to wear any type of brace. However, some patients may find it more comfortable to have the collar during the first week following surgery. Please request this in the hospital if you feel this would be helpful. You are free to turn and nod your head as you feel fit. Non-impact aerobic exercise can be initiated as soon as you feel comfortable. I would restrict any heavy impact activity for the first six weeks. I would not engage in impact activities for a minimum of 6 weeks.

You may find it more comfortable to eat soft foods for the first 24 to 48 hours after surgery. Some patients may experience some swallowing difficulty or may have a sore throat post-operatively. You may find that ice applied to the front of the neck can help reduce this irritation. Pain medication should be weaned down after the first week of surgery. Tylenol is ok at any time.

At your first follow-up visit, you will be instructed in skin massage techniques to minimize scar formation. I will also review the radiographs with you and show you the plate and graft. At that visit, you will no longer have any activity restrictions. I do ask that future follow-up appointments be kept at 3 months and 6 months following surgery for routine radiographs.

Pre-Operative:

There are no specific preoperative exercises or preparation that is needed. Since the surgical approach is from the back of the neck, you may wish to have a haircut that includes a close trim on the back of the neck prior to surgery. This will facilitate us being able to shave this area during surgery and apply a post-operative bandage. Since there will be a bandage in place following surgery, please bring a loose-fitting shirt and/or a blouse to wear post-operatively.

Hospital Stay:

Most patients are discharged home the next day following the surgical procedure. Rarely, you may stay a second night. The surgical procedure should take approximately 2.5 hours. Following surgery, there will be a bandage on the back of the neck. I do leave a small drainage tube in place, so that any bleeding that occurs overnight will be collected in the drain canister. This drainage tube will be removed in the morning by our Ortho residents and/or our Orthopedic mid-level providers. Prior to discharge home, we will change the bandage and put a smaller one on for the trip home.

Post-Operative:

The dressing you are discharged with should remain in place for 24-48 hours. There are surgical staples holding the skin incision together. You may wish to put a lightweight gauze dressing over these staples for the first two weeks prior to their removal. You can shower, but please keep the incision and bandage dry. You will be given a soft cervical collar to wear for the first two weeks. You can remove this to shower and/or shave but use it for comfort during these first two weeks. You can turn and nod your head in the collar as you wish. Please refrain from any heavy lifting or impact activities for the first six weeks following surgery. Non-impact aerobic exercise can be initiated as soon as you feel comfortable.

You will be given a follow-up appointment for two weeks following surgery. At this visit, we will inspect your incision, remove the surgical staples, and apply steri-strips to the incision. Please keep these steri-strips dry for 48 hours. After that, you may remove them as they become loose.

I would like you to discontinue the cervical collar at the two-week follow-up visit. At that point, I would encourage you to begin flexion, extension, and rotation exercises to maximize your neck motion. By this visit, I do expect that you will have weaned off of your post-operative narcotic pain medication. It is fine to use Tylenol and/or Ibuprofen or Aleve at any point following surgery.

You will next be seen at the six-week post-surgery visit as well as at three months and six months. I would expect by the three-month point there will be no activity restrictions.

Pre-Operative:

With a disc herniation, you should refrain from heavy lifting or impact activities. These activities may worsen your disc herniation prior to surgery. At your preoperative visit with our physician’s assistant, options for anesthesia will be discussed. Most lumbar microdiscectomies can be performed under an epidural anesthetic. A light sedative is given during the epidural as well. You will not recall being in the operating room, but you will wake up without the after-effects of a general anesthetic.

Epidural anesthesia is not appropriate for every microdiscectomy patient. These specifics will be discussed at your pre-operative visit.

Surgery:

A microdiscectomy surgery typically takes between 60 and 90 minutes. Once your anesthetic has worn off, you will be able to walk around the postoperative area prior to discharge home that same day.

Post-Operative:

The bandage that you go home with should be kept on for 48 hours. Underneath, there are steri-strips, or tapes, across the incision. These should be kept dry for four days. Once they get wet, they should peel off on their own. If they have not peeled off by two weeks they can be removed.

It is okay to shower postoperatively, just keep the dressing out of the water.

Most patients use post-operative pain medication only for several days. If you are finding that your pain is still significant following one week, you should let us know. You may drive, walk, and return to normal sedentary activities as soon as you are comfortable. Typically, within a few days. Please refrain from any lifting while bent at the waist, or high-impact activities for the first four weeks. Once your first post-operative visit has occurred, activities will be increased at that point. Return to full activity is expected between 6 and 8 weeks post-operatively.

Pre-Operative:

There are numerous indications for posterior lumbar fusion. These include spinal deformity, spondylolisthesis, or severe disc degeneration. Spinal fusion can be performed with bone graft alone, bone graft plus screw and rod instrumentation, or with a spacer cage placed within the disc space. The specific indications for which type of fusion you will be receiving will be discussed at your preoperative office visit.

Surgery:

Posterior lumbar fusion surgery typically takes between two and three hours to perform. You will be under a general anesthetic during this time period. You will most likely stay as an inpatient in the hospital for two or three nights. Most patients do not have a urinary catheter during or following the procedure. A small drain tube will be removed on the morning after surgery.

On the first post-operative day, you will be assessed with nursing staff and physical therapy staff, and usually stand and walk a short distance. Prior to discharge, you will be independent in walking, getting in and out of bed, and going to the bathroom. If you have stairs to climb at home the therapist will practice this with you in the hospital prior to discharge.

Post-Operative:

Please keep the dressing intact over your wound for 48 hours. Underneath the dressing there are steri-strips covering your incision. These should be kept dry for four days. You may shower, but please keep the dressing and steri-strips out of the water over the first four days.

You may begin a walking program immediately upon discharge. Please don’t overdo this! A short 10- to 15-minute walk per day is all that we ask you to do over the first three to four weeks. Please refrain from any excessive bending, twisting, or lifting over 10 pounds. There will not be a brace prescribed following surgery.

Your first postoperative office visit should occur by six weeks. At this point we will go over your x-rays, and increase your activities as appropriate. Most patients have no restrictions by 12 weeks post-operatively.

Spine Conditions

• Compression Fracture (Trauma)
• Degenerative Disc Disease
• Herniated Disc – Cervical
• Herniated Disc – Lumbar
• Osteosarthritis
• Osteoporosis
• Sciatica
• Scoliosis
• Spondylolisthesis
• Stenosis – Cervical
• Stenosis – Lumbar
• Tumors

Spine Procedures

• Cervical – Anterior Cervical Discectomy, Fusion – Instrumented (ACDF)
• Cervical – Cervical Laminectomy, Fusion – Instrumented
• Cervical – Cervical Laminoplasty
• Cervical – Posterior Cervical Laminotomy
• Computer–Assisted Spine Surgery
• Lumbar – Anterior Lumbar Interbody Fusion (ALIF)
• Lumbar – Laminectomy
• Lumbar – Laminectomy, Fusion – Instrumented
• Lumbar – Laminectomy, Fusion – Uninstrumented
• Lumbar – Minimally Invasive Approach (PLIF)
• Lumbar – Minimally Invasive Approach (TLIF)
• Lumbar – Partial Discectomy
• Lumbar – Posterior Lumbar Interbody Fusion (PLIF)
• Lumbar – Transforaminal Lumbar Interbody Fusion (TLIF)