Once it has been determined
that surgery is the right treatment for you, and your surgery has been
scheduled, several appointments must be made.
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A neurosurgeon may assist
your surgeon during the procedure. The neurosurgeon begins the surgery
and releases the pressure around the nerve by removing bone or disc material.
Once this is completed, your surgeon will perform the fusion and implant
the instrumentation, which stabilizes your back. You must make an appointment
with the neurosurgeon before your surgery, if you have not already been
to see the neurosurgeon. We will provide your neurosurgeon with a copy
of your surgeon's office notes. You should take all x-rays and special
tests (MRI, CT, myelogram, discogram, bone scan) to this appointment.
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American Red Cross.
Lumbar (low back) fusions only. When you have your surgery date, call
the American Red Cross Special Collections, 918/831-1157, and schedule
an appointment to donate blood that can be given back to you during and
after your surgery. Remember, you can only donate one unit of blood per
week, and there must be at least one week between your last donation and
your surgery. That means if you are going to donate two units of blood,
you need to donate one unit of blood, wait a week and donate the second
unit, and then wait another week before you have the surgery. The Red Cross
is aware of this time constraint and will help you set up a schedule to
donate.
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Back Brace. For lumbar
fusions, the nurse will fit you for a sports brace in our office. Take
the brace with you when you go to the hospital for surgery. During lumbar
fusion surgery, the paraspinal muscles are elevated, and the existing bone
is scraped to induce the bone to accept the new graft bone, which is harvested
from your pelvic region. The harvested graft bone is broken into small
particles and laid between and over the site of the fusion. Large screws
are inserted into the vertebral bones and interconnecting rods are put
in place to secure the bones in a rigid fashion.
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Cervical Collars.
For cervical (neck) fusions, the nurse will give you a prescription for
your cervical collars. You should make an appointment to be fitted for
the collars. Please have the collars with you when you go to the hospital
for surgery.
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Quit smoking. Smoking
significantly increases the likelihood of fusions not healing. If you are
a smoker, please quit. If you have trouble quitting, ask your doctor for
assistance.
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Make an appointment to
see your doctor a couple of days before your surgery if your last appointment
was longer than three or four weeks before your surgery date.
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Medication. Aspirin and
anti-inflammatories can affect your blood's ability to clot. If you are
taking any of these medications or products, stop taking them 10 days before
the surgery. Heparin and Coumadin also affect your blood's ability to clot.
Please let your doctor or his nurse know if you take either of these medications.
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Bone Growth Stimulators
(low backs only). Research has shown that people who smoke, or have health
conditions such as diabetes, lupus and/or prior failed fusions have an
increased risk of the fusions not healing. Your doctor will discuss this
with you and may prescribe a bone growth stimulator that will be implanted
at the time of the surgery. This device will stimulate your bones
to grow and increase the chance of your fusion healing.
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Pre-Hospital Visit. You
will need to contact our Surgery Scheduling Nurse. The nurse will give
you information about your pre-hospital visit. You will also need to contact
the Surgery Scheduling Nurse the day before your surgery between 2:00 -
4:00 p.m. for the exact time of your surgery.
NO FOOD, DRINK, CHEWING
GUM, TOBACCO OR BREATH MINTS AFTER MIDNIGHT THE NIGHT PRIOR TO THE SURGERY.
DO NOT BRUSH YOUR TEETH.
If you develop any open wounds
such as cuts, scratches, or a rash over the operative site, an infection,
or any other illness before surgery, you need to call our office immediately.
It may be necessary to reschedule your surgery.
The following recommendations should be followed immediately after your surgery.
- Incision Care. In some surgeries, staples may be used to close the incision. Once the staples are removed, we put steri-strips across the incision. These will fall off in a few days. If they have not come off, take them off yourself. You do not need to wear a bandage unless you have drainage.
You may take a shower 24 hours after your staples are removed, using your regular soap. Towel-dry your incision. A bandage is not needed. Do not bathe or soak in a bathtub until your incision is healed over with skin. This will probably be in another 1 1/2 to 2 weeks.
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Activity/Exercise
All you should do at this time is walk. Extend yourself one day, then take the next day off, or go for a short walk. Alternate these days. One day push yourself, the next day, take it easy. You may start driving again once your doctor has approved that activity. Also consult with your doctor before resuming sexual activity.
- Return Appointment. Your doctor will want to see you in one month. At this appointment we will take x-rays and begin your physical therapy or home exercise program.
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What to Expect. It takes approximately four to six months for your fusion to heal. Even though your fusion is healed and your back is stabilized, it may take an additional 12 months for your nerves to recover as much as they are going to. Typically, people will experience popping in their back two to three months after surgery. This is normal.
Many people have difficulty sleeping due to the change in their activity levels and discomfort. If you have trouble sleeping, try not to take naps during the day, wake up early in the morning, read before sleeping, reduce the amount of caffeine you drink and eat, such as coffee, tea, and chocolate. Manage your pain medication and muscle relaxers so you take them 30 minutes before going to bed. Your doctor may prescribe a muscle relaxer or sleep agent that can cause you to be sleepy. Increasing your activity by walking will help your body feel tired.
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Medications. Prescriptions can be refilled between 9 a.m. and 4 p.m. Monday through Friday. Please have your pharmacist call us for refills or call the office and leave a message for us to call if you need to discuss your medication or change your medication. We will return your call as quickly as possible. Please call us before you run out of medication. We may not be able to refill your medication the same day you call.
Your admitting physician will manage your medications. Please contact the doctor's office for all medication questions or refills.
Select from the list below for information from Central States Orthopedic physicians.
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