Home Care after Anterior Lumbar Interbody Fusion (ALIF) Surgery HF#4957

 

Surgery Date: _____________________________________________

 

Doctor:___________________________________________________

 

This handout will review the care you need to follow once you are home.  If you have any questions or concerns, please ask your nurse or doctor.  Our staff is here to help you.  If you have questions after you are at home, please call the numbers at the end of this handout.

 

Activity

 

Start the walking program once you are home.  You may climb stairs.

 

Walking Program

 

These are general guidelines for a walking program.  Discuss with your doctor or nurse the walking program for your type of surgery.

 

Day 1:  Walk the length of the hallway at home 3-4 times, or walk to the end of the driveway and back once in the morning and again in the afternoon or evening.

 

Day 2:  Walk 1/2 block or equal to that amount indoors, once in the morning and again in the afternoon or evening.

 

Day 3:  Walk 1 block in the morning and 1 block again in the afternoon or evening.

 

Day 4:  Walk 2 blocks in the morning and 2 blocks again in the afternoon or evening.

 

Day 5:  Walk 3 blocks in the morning and 3 blocks again in the afternoon or evening.

 

Each day increase the distance you walk.  Let comfort be your guide to how much you can do.  Slowly return to your daily routine.

 

Smoking

 

We strongly suggest you quit smoking, avoid tobacco products, and second hand smoke.  Smoking will delay bone healing.  It is best not to smoke for at least 4 – 6 months after surgery.

 

Compression Stockings (TEDS)

 

To improve blood flow and decrease the risk of getting a blood clot, you need to wear elastic stockings (TEDS) until you are walking and back to your normal routine.  Remove the TEDS 2 times each day for one hour at a time.  You should sleep with them on. You may wash the TEDS with soap and water.  Let air dry.

 

Sitting

 

You may sit for any length of time based on your comfort level.  You should change your position at least every 30 minutes. 

 

Sleeping

 

Sleep either on your back, stomach, or side.  You may use pillows for support. Place pillows behind your knees when lying on your back.  Place pillows behind your back and between your legs when lying on your side.

 

Bathing

 

You may shower 5 days after your surgery.  No tub baths for 2 weeks. 

 

Driving

 

Do not drive while on narcotic pain medicine.  Do not drive until your reflexes return to normal.  Check with your doctor before driving. 

 

Sexual Activity

 

After 1 week, you may resume sexual activity, if comfortable.

 

Limits

 

• Do not lift more than 10 lbs (about 1 gallon of milk) for the first 6 weeks.
• Do not bend at the waist.  You should squat with your knees.
• No twisting.
• No sports except the walking program until your first follow-up visit.

 

Incision Care

 

Proper care of the incision helps to prevent infection.

• Keep the incision clean and dry. 
• Change the dressing every other day or as needed.
• If there is no drainage, you may remove the dressing in 2 days. 
• The incision has been closed with sutures under the skin and covered with steri-strips (small pieces of tape) on the skin.  These will slowly peel off as they get wet when you shower.  You may gently remove them after 10 days.
• Check the incision daily to be sure it is clean and dry.Check for redness, swelling or drainage.  Some redness and swelling is normal.
• A small amount of clear or slightly blood-tinged drainage from the incision is normal.
• Do not wash directly over the incision.  Wash around the incision gently with soap and water and then let air dry.
• Do not use any creams, lotions, ointments, or alcohol near or on the incision.

 

Temperature

 

Take your temperature twice a day for 10 days.

 

 

Pain Management

 

You may have an increase in pain and numbness in the low back and legs during the healing phase.  This is normal.  It is caused by swelling of tissue in your low back.  To reduce the pain, there are many options to try.

 

Ice Therapy Method

 

Ice the incision area for 15-20 minutes as often as needed.  Do not put the ice directly on the skin.  Use a pre-made ice pack or put ice in a plastic bag and wrap in a towel before you use it.

 

Pain Medicine

 

You may also need to use pain medicine.  If needed, take it as prescribed. 

 

• Narcotics:  Do not increase the prescribed dose without checking with your doctor or nurse.
• Neurontin^®/Gabapentin:  If you have been taking these before surgery, you should keep taking them unless you have been told not to.
• Tylenol^® (acetaminophen):  You may take up to 4000 milligrams per day. Percocet^® and Vicodin^® also contain Tylenol^®.  Do not take Tylenol^® if you have liver disease.  Do not take it without checking with your doctor. 
• Do not take Non-Steroidal Anti-Inflammatory drugs (NSAIDs) (i.e., Ibuprofen, Motrin®, Advil®, Aleve®, etc) for 3 months.  Do not take aspirin for 3 months unless prescribed by a cardiologist or your local doctor for a heart condition.
• After 3 months, you may use Non-Steroidal Anti-Inflammatory drugs (NSAIDs) (ie., Ibuprofen, Motrin®, Advil®, Aleve®, etc).  These may be used if you do not have stomach or peptic ulcer disease, kidney/liver disease, or bleeding problems.  Do not take these if you have heart disease or high blood pressure.

 

If you are not sure about a medicine, please call the Spine Clinic. 

 

 

Constipation

 

The combination of surgery, narcotic pain medicine, decreased activity level. and a change in your diet, can play a role in getting constipated.  It is common to have a problem with your bowels after surgery.  Please see Health Facts for You Constipation from Opioids (Narcotics) found in the Post-Operative Orthopedic Spine Surgery Packet.

 

Abdominal Discomfort

 

After anterior spine surgery, you may have abdominal discomfort.  It does not pose any serious health problems and most often goes away within 24-48 hours.  You may lessen the discomfort if you:

 

• Walk around the house.
• Lie on your back with your feet up on several pillows (above the level of your chest).
• Gently rub your abdomen being careful of the incision.

 

In rare cases, men may have scrotal swelling and bruising.  In order to decrease swelling, elevate the scrotum and use the ice therapy method described.

 

When to Call the Doctor

 

• Increased pain, swelling, or redness in or around the incision site.
• Sudden increase in pain or pain not relieved by medicine.
• An increase in the amount of drainage, change in the color of drainage, or any odor from the incision.  Be ready to describe what the drainage looks like, how it smells, and how much there is.
• A temperature above 100.5ºF or 38.1° C for 24 hours.
• Abdominal discomfort that persists longer than 24-48 hours.
• A “new” chest pain or “new” problem with breathing.
• Redness, warmth, or tenderness in the back of the calf of your leg(s).
• A persistent headache that is different when sitting or lying down.
• Problems urinating or having control of your bladder or bowel movements.

 

Return to Work

 

When you return to work will depend on your recovery and the type of work you do.  In most cases, if your job requires you to lift more than 10 lbs, you will not be able to return to work for 6-12 weeks.  If you lift less than 10 lbs, you could return to work in 2 weeks.  You must discuss this with your doctor.

 

Refills

 

The Spine Clinic staff will work with you to balance pain medicine, pain management, and activity.  The goal is to taper you off your pain medicine by 6 weeks after surgery.  If you need a refill on your pain medicine, call the Spine Clinic and ask for the nurse.  Please call when you have a 2 to 3 day supply left of your medicine.  Be ready to give the name and phone number of the drugstore where you want to pick up a refill.

 

Future Clinic Visits

 

The nursing staff will help you schedule your first clinic visit for 6 weeks.  All other clinic visits will be as needed.

 

Important Phone Numbers

 

If you have questions or concerns, please call the Spine Clinic.

Monday through Friday between 8:00 AMand 5:00 PMat (608) 265-3207.

 

Nights and Weekends

 

Call the paging operator at (608) 262-0486.  If you live out of the area, call 1(800) 323-8942.  Ask for the “orthopedic resident on call”.  Leave your name and phone number with the area code.  The doctor will call you back.

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 10/21/2010

Copyright © 08/25/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4957

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