Home Care Instructions after Thoracic and Lumbar Anterior/Posterior Spine Fusion Surgery HF#7025



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 listed at the end of this handout.

 

Activity

 

You should slowly increase your activity.  In most cases common sense will tell you when you are doing too much.  On the other hand, doing too little can delay the return of your strength and stamina.  You may climb stairs.  No sports except the walking program.  Begin the walking program once you are home. 

 

Day 1:  Walk the length of the hallway at home 3-4 times in the morning and again in the afternoon or evening.

 

Day 2-6:  Increase the distance you walk by a small amount each day.

 

Day 7:  Walk to the end of the driveway twice a day.

 

Day 8:  Walk a 1/2 block twice a day.

 

Day 9:  Walk 1 block twice a day.

 

Day 10:  Walk 1 ½ blocks twice a day.

 

After Day 10:  Increase the distance you walk as you are able.

 

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.

 

Sitting

 

You may sit for any length of time based on your comfort level.  You should change your position 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 for 2 weeks or while taking narcotic pain medicine.  Do not drive until your reflexes return to normal.  Check with your doctor before driving.

 

Sexual Activity

 

No sex for 3 weeks.  After 3 weeks, you may resume sexual activity if comfortable. 

 

Spine Precautions

 

• Log roll.   Logrolling is rolling side to side in bed while keeping your spine straight.
• No bending at the waist.  You may squat with your knees.  
• No twisting.
• Do not lift more than 10 lbs (about 1 gallon of milk) for the first 6 weeks.

 

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.

 

Incision Care

 

Proper care of the incision helps to prevent infection.

• If the incision is clean and without drainage, you may stop wearing the dressing after 5 days.
• Change the dressing every other day or as needed.
• Keep the incision clean and dry. 
• 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 take a 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.

 

Temperature

 

Take your temperature twice a day for 10 days.

 

Note

If you had a thoracotomy, a surgical incision of the chest wall between two ribs, it is important to cough and deep breathe and use the incentive spirometer to help prevent pneumonia.  Please keep doing these breathing exercises for 1-2 weeks after surgery.

 

 

To cough and deep breathe

• Place a pillow over your chest to decrease the pain while coughing.
• Breathe in deeply and slowly through your nose. Hold it for a few seconds.
• Exhale slowly through the mouth.
• Repeat twice more.
• Breathe in again; hold it, and then cough.

 

To use the incentive spirometer

• Exhale and place your lips tightly around the mouthpiece.
• Take a deep breath.  Slowly raise the Flow Rate Guide between the arrows.
• Hold it.  Continue to inhale, keeping the guide as high as you can for as long as you can, or as directed by your nurse or respiratory therapist.
• Remove the mouthpiece and breathe out as usual.
• Slowly, repeat 10 times each hour while you are awake.

 

 

Pain Management

 

During the healing phase, you may have an increase in pain and/or numbness in the low back and legs.  This is normal and is caused by tissue swelling and recovery of nerves in your low back.  To reduce the pain, there are many options to try.

 

• 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.
• Do not sit more than 15-30 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. 

 

 

• 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.   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. 

 

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, “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.  You must discuss this with your doctor.

 

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 at (608) 265-3207, Monday through Friday, 8:00 a.m. to 4:00 p.m. 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 in 4-6 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#7025

Print Health Fact For You