Lumbar Spine Surgery Discharge Instructions

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For Post-operative Decompressive Laminectomy, Laminotomy and Discectomy Patients

1. SITTING is recommended for LIMITED PERIODS OF TIME DURING THE FIRST 2 DAYS post-operatively while being extra cautious when getting in & out of bed (use the "log-roll" technique) and using the toilet.

2. Once you begin to sit, use ONLY a straight back chair (such as a dining room, kitchen or "club-type" chair or a sturdy "wing back" chair). Each day increase the time & frequency that you sit. (Example: 1st day, sit 3 times for 15 minutes each / 2nd day 4 times for 20 minutes each / 3rd day 5 times for 25 minutes, etc.) If there is pain after a few minutes, GET UP from that position.

3. LIE ONLY ON A BED. DO NOT lie on the floor or sofa and avoid using a "recliner".

4. NO BENDING, STOOPING, PUSHING, LIFTING or STRAINING. Lift ONLY what you can lift easily with ONE ARM (approximately 15 lbs.)

5. BATHING POST-OPERATIVELY. For MINIMALLY INVASIVE SURGERY you may shower the morning after surgery. For ALL OTHERS, you may shower 4 days post-operative (the first day is the day AFTER surgery.) IN ALL PATIENTS, do not soak the incision. If the outer dressing falls off, it need not be replaced; however, DO NOT DISTURB THE "STERI-STRIPS" that were applied at surgery. In the unusual case where surgical skin clips or sutures have been used, you will be given instructions. AVOID TUB BATHING for at least the first 14 days.

6. Begin walking in the house and progress to outdoors. Take someone with you the first few times. Slowly increase the distance each day so that you will be walking 1 mile/day by your 2nd post-operative week, 2 miles/day at 2 weeks post-operative. Hopefully by 2 months post-operative you will be walking 4 miles/day. If you feel soreness, reduce the distance and REST. These are GUIDELINES, NOT RULES.

7. After leaving the hospital you will be expected to return to our office for follow-up between 10 and 14 days post-operatively. You will get your next set of instructions upon your return. For patients from out-of-town or country, there will be specific instructions.

8. PAIN IS A RED FLAG TELLING YOU TO REST. Avoid taking pain relieving medication in anticipation that something you will do is going to cause pain.

9. CALL THE OFFICE if you develop a fever of over 101(F) orally or if there is excessive wound redness, swelling, drainage or infection. If you develop a low grade fever, keep a chart of your temperature pattern at 8 AM, 12 noon, 4 & 8 PM. Bring the chart to the office at your next visit.

10. If you question whether or not you can do something beyond the instructions given, it is safe to assume that the answer will be NO.

11. FOLLOW UP: After leaving the hospital you will be expected to return to our office for follow-up between 10 and 14 days post-operatively. You will get your next set of instructions upon your return. For patients from out-of-town or country, there will be specific instructions. Call our office for an appointment (972.566.6444) or if you have questions or concerns. For GENERAL MEDICAL PROBLEMS or MEDICATION QUESTIONS, CONTACT your personal physician.

12. Medications: For pain management, you will usually be given a prescription for a drug like Vicodin (hydrocodone). For additional pain medication, try Extra strength Tylenol or similar agent. DO NOT USE ANY ASPIRIN or ASPIRIN-containing medication. DO NOT use ADVIL (ibuprofen), Aleve (naproxen) or similar medication. These interfere with "platelet" function, which is an integral component of the clotting mechanism. You may take Celebrex (celecoxib) if your general physician finds that it does not interfere with your OTHER MEDICATIONS and you are NOT ALLERGIC to SULFA-containing drugs.

13. We often use Celebrex (celecoxib) as part of a post-operative "pain control" program. This involves taking 400 mgm prior to operation (given with our routine pre-operative medication in the hospital) and then again within 12 hours post-operatively. This will be repeated with 400 mgm by mouth twice daily for two (2) subsequent days. You will be given a prescription for this prior to discharge from hospital. Accept NO SUBSTITUTES from your pharmacy.

14. "LISTEN TO YOUR BODY" This is one of the most important guidelines. Your body will try to let you know if you are doing something that it "doesn't like".

15. Driving or Flying: For Minimally Invasive Surgery patients, you may begin to drive once you are sufficiently comfortable to do so. Avoid sitting for more than 1 hour and if necessary, take rest stops every hour and walk for a few minutes. For patients who must fly (such as out-of-town or out-of-country patients) we prefer that you remain in Dallas for at least 3 days post-operative. First or Business Class seating accommodations are much preferred when returning to your home. For all others (including Spinal Cord Tumor patients), we recommend delaying trips for at least 2-6 weeks unless absolutely necessary. Discuss this with the Neurosurgeon for further instructions.

16. FOR SPINAL CORD TUMOR PATIENTS: You will receive additional specific instructions beyond those listed above.