Our knowledge of orthopaedics. Your best health.

Medications

Some medications can affect your surgery by causing bleeding or interfering with anesthesia. These medications include aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen. Certain over-the-counter dietary supplements and herbal remedies can also interfere with surgery.

Your surgeon will tell you which supplements and medications you should stop taking in preparation for your procedure.  

Learn more: Preparing for Surgery: Medication Safety Checklist

Donating Blood

It is not usually necessary to donate blood for low back surgery. However, there is always a chance that some blood loss will occur during the procedure. Your surgeon will talk with you about the advantages and disadvantages of donating your own blood versus using someone else's blood. If you decide to donate your own blood, your surgeon may prescribe an iron supplement to help build up your blood before surgery.

Advance Planning

You will be able to walk after surgery, but you after you return home you may need assistance with activities like washing, dressing, cleaning, laundry, and shopping. Before your procedure, make arrangements to get help with these activities for the first few weeks after surgery.

Even after minor spine surgery, your doctor may recommend that you do not drive for a period of time. For this reason, you will need to arrange in advance for transportation to and from your hospital appointments and other places that you need to go during this time.

You should consult your doctor in advance if you have an extended car trip planned during your recovery. Your surgeon may recommend that you postpone your trip until your recovery is complete.

Before Your Operation

If a hospital stay is necessary after surgery, patients are usually admitted on the day of surgery.

After admission, you will be taken to the preoperative preparation area where you will be interviewed by a doctor from the anesthesia department. The anesthesiologist will review your medical history and physical examination reports.

Together, you and the anesthesiologist will determine the type of anesthesia to be used. In some cases, this discussion will take place during an outpatient visit up to 7 days before surgery.

The most common types of anesthesia used for low back surgery are:

• General anesthesia (you are asleep for the entire operation)
• Spinal anesthesia (you may be awake, but you will have no feeling from the waist down)

You should tell the anesthesiologist about any past or current health issues and about any previous surgeries you have had. In addition, let the anesthesiologist know if you or anyone in your family has had problems with anesthesia in the past.

Surgical Procedure

Low back surgery, as well as neck surgery, usually takes 1 to 3 hours, depending on the procedure. some bigger surgeries may last up to 10 to 12 hours. Ask your surgeon what the anticipated duration of your surgery will be.

When surgery is over, you will be moved to the recovery room, where you will be observed and monitored by a nurse until you awaken from the anesthesia. You will have an intravenous (IV) line inserted into a vein in your arm (likely inserted prior to surgery). You may also have a catheter inserted into your bladder to make urination easier.

When you are fully awake and alert, you will be taken to your hospital room.

For outpatient procedures, the nurses in the recovery room will make sure that you are able to walk, eat, and go to the bathroom before discharging you home. They will also go over any postoperative instructions with you and make sure that you understand the directions for your pain medications. You may want to talk to the nursing staff about timing pain medications for just before discharge to make your trip home more comfortable.

Complications

The incidence of complications after low back surgery is low. Risks for any type of surgery include bleeding, infection, and reaction to anesthesia. Complications that are specific to spine surgery include:

• Difficulty with urination (retention)
• Difficulty with intestinal function
• Heart attack
• Stroke
• Blood clots
• Recurrent disk herniation
• Problems related to rods or screws
• Nerve damage resulting in pain, numbness, and/or weakness
• Spinal headache

Warning Signs

Your doctor will talk with you about how to recognize the warning signs of a blood clot or infection. These complications are most likely to occur during the first few weeks after surgery.

Blood Clots

Warning signs include:

• Swelling in the calf, ankle or foot
• Tenderness or redness, which may extend above or below the knee
• Pain in the calf

Occasionally, a blood clot will travel through the bloodstream and may settle in the lungs. If this happens, you may experience sudden chest pain and shortness of breath or coughing. If you experience any of these symptoms, notify your doctor immediately. If you cannot reach your doctor, call 911 or have someone drive you to the emergency room.

Watch: Preventing Blood Clots After Orthopaedic Surgery

Infection

Infection following spine surgery occurs rarely. Warning signs of an infection include:

• Redness, tenderness, and swelling around the edges of the wound
• Drainage from the wound
• Pain or tenderness
• Shaking chills
• Elevated temperature, usually above 100°F if taken with an oral thermometer

If any of these symptoms occur, you should contact your doctor immediately or go to the nearest emergency room.

Wound Care

• If your wound was closed with stitches (sutures) or staples, they will be removed approximately 2 weeks after surgery.
• If your wound was closed with absorbable sutures, they do not have to be removed.
• If you have wound drainage after you are home, cover the wound with a bandage and call your surgeon. 

Diet

• Some loss of appetite is common after surgery.
• During your recovery, it is important to eat well-balanced meals and drink plenty of fluids.
• Your doctor may recommend an iron supplement or vitamins before and after your surgery.
• It is not advisable to go on a weight loss diet right after surgery. The lack of essential nutrition may delay wound or bone healing. Instead, you should focus on eating nutritious foods and getting adequate quantities of protein and fiber.

Ask your doctor if you have questions about your post-surgery diet. 

Activity

• Many people experience a loss of energy after major surgery, but this improves over time.
• It is very important that you do not stay in bed for prolonged periods of time right after surgery. You should get up every hour or so and take at least a few steps. This will help with your rehabilitation and decrease the chance of blood clots.
• Your doctor may prescribe an exercise program designed to gradually increase your strength and stamina.
• Initially, your doctor will recommend that you participate in light activity like walking. Later, you will be encouraged to swim or use an exercise bike or treadmill to improve your general physical condition.