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Home Care Instructions after Cervical Spinal Fusion (Anterior & Posterior) Surgery HF#4499

Orthopedics

  

 

   

Surgical 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.

 

For Patients with a Hard Collar

 

For the first 6 weeks, you must wear the hard collar at all times even when you shower and sleep.  When you return for your first clinic visit you may be given a soft collar to be worn in place of the hard collar. 

 

Bathing with a Hard Collar

 

You may shower 5 days after surgery with the hard collar on and padding removed.  To remove and apply padding, follow the instructions shown to you at the time your brace was fitted.  When finished bathing, remove the collar and place a clean dressing over the incision if needed.  Put the hard collar back on with clean and dry pads.  No tub baths for 2 weeks.

 

For Patients with a Soft Collar

 

For the first 2 weeks, you must wear the soft collar at all times, except when you shower.  After 2 weeks, use the collar for comfort as needed. 

 

Bathing with a Soft Collar

 

You may shower 5 days after surgery.  Remove the collar after you are in the shower.  Try to keep the collar dry.  When you finish bathing, place a clean dressing over the incision if needed.  Put the soft collar back on.  No tub baths for 2 weeks.

 

For all Patients

 

No sports except for walking and in some cases, using an exercise bike.  No impact aerobics.  Walking is your form of aerobic exercise until your doctor tells you otherwise.  Slowly return to your normal routine.  There are no limits on stair climbing or sitting.  Use your comfort level as a guide as to the length of time you are able to sit or climb stairs.  Most patients find they need to change positions after 30 minutes of sitting.  

 

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 activities.  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.

 

Note

 

It is common to have a sore throat or hoarse voice for a few weeks after surgery.  You may also feel a “catching” sensation in your throat.  You may find lozenges and eating soft foods helps. 

 

If you have any trouble breathing, cannot swallow, or have any major voice changes, call the Spine Clinic right away and ask to speak with the nurse.  After clinic hours, call the doctor on-call. See phone numbers listed.

 

Sleeping

 

If you have a hard collar, sleep on your back or side with the collar on for the first 6 weeks.  If you have a soft collar, wear the collar when sleeping for the first 2 weeks.  Place a cushion under the back or side of your neck for comfort.

 

Limits

 

  • No driving for the first 2 weeks or while wearing a hard or soft collar.
  • No driving while taking narcotic pain medicine.
  • No driving until your reflexes return to normal.
  • No lifting more than 10 lbs (about 1 gallon of milk) for the first 6 weeks.

 

Sexual Activity

 

No sex for 1 week.  After 1 week, you may resume sexual activity, if comfortable.

 

Incision Care

 

Anterior Cervical Fusion

The incision is 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.

 

Posterior Cervical Fusion

The incision is closed with staples and will be removed in 2 weeks at the Spine Clinic.  Keep a clean dressing over the incision.

Proper care of the incision helps to prevent infection.

  • Keep the incision clean and dry. 
  • Change the dressing every other day or as needed.
  • 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

 

During the healing phase, it is common to have some pain, numbness, tingling, and weakness in your neck or arms.  If you have an increase in pain once you return home, try these options to decrease the pain. 

 

  • Ice the neck for 15-20 minutes each hour for 4 hours.  Do not put the ice directly on the skin.  Use a pre-made ice pack or put ice in a plastic bag then wrap the ice pack or bag in a towel before you use it.
  • Do not sit more than 15 to 30 minutes at a time for the next 48 hours.
  • Reduce your activity for the next 48 hours (i.e. walking).

 

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.
  • Tylenol® (acetaminophen):  You may take up to 4000 milligrams per day. Percocet® and Vicodin® also contain Tylenol®.  If you have liver disease, do not take Tylenol® without checking with your doctor first.   
  • 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 for a heart problem by a cardiologist or your local doctor. These medicines delay bone healing.

 

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.  After surgery, it is common to have a problem with your bowels.  Please see Health Facts for You Constipation from Opioids (Narcotics) found in the Post-Operative Orthopedic Spine Surgery Packet.

 

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.
  • 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.

 

Return to Work

 

When you return to work will depend on your recovery and the type of work you do.  Discuss with your doctor before you return to work.

 

Refills

 

The Spine Clinic staff will be working with you to balance pain medicine, pain management, and activity.  The goal is to taper you off of your pain medicine by 6 weeks after surgery.  If you need a refill on your pain medicine, call the Spine Clinic 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 in 2 weeks if you have staples.  For all other patients, your first clinic visit will be scheduled for 6 weeks.  All other clinic visits will be as needed.

 

Phone Numbers

 

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

Monday through Friday between 8:00 AM and 5:00 PM at (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: 05/06/2010

Copyright © 05/06/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4499

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