Lumbar fusion surgery — one of the most common types of spine surgery — is an operation to fuse vertebrae in the lower back. It takes hours to complete and many weeks of recovery. Knowing what to expect, how to prepare for spinal surgery, and what to plan for during the immediate and longer-term recovery period is key to a successful recovery. Below are some of the instructions and recommendations I give to my patients having this surgery at MOC.
If you undergo this procedure, make sure to follow your own doctor's instructions for the recovery period to ensure that you heal as quickly and completely from surgery as possible.
Caring For Your Lumbar Fusion Surgery Wound
Your provider should give you specific instructions for how to care for the surgical area while you're recovering. Your wound will likely be covered with a dressing called an Aquacel bandage after surgery. If your Aquacel dressing remains in tact, you can shower the second day after your procedure. You may feel dizzy or light-headed due to the combination of medication and warm water, so using a shower chair and having someone assist you is recommended for safety.
Don't be alarmed if the Aquacel dressing absorbs some blood and fluid in the immediate post- operative period — this is normal! The dressing will only require changing if it becomes fully saturated or leaks. When you change the bandage, inspect the incision for redness, excessive drainage or swelling around the site, and contact your doctor if anything raises concern.
You can remove this waterproof bandage seven days after surgery. No additional bandage will be necessary, but you may want to cover the site with gauze to protect the area from contact with your clothing, which may be irritating.
It's possible you have a Tegaderm dressing. If this is the case, follow your physician’s directions for how to care for the wound and manage the dressing after surgery.
Dealing With Medications
After surgery, take medication only as prescribed by your surgeon. Avoid anti-inflammatory medication such as the following for up to three months:
- Arthritis medication
Not only can these medications delay the healing process, but they can also increase bleeding at the incision site. Check with your surgeon before taking these medications after surgery.
Do not drive, operate machinery, perform any complicated tasks or even make important decisions while under the influence of any pain medications — narcotics — after surgery. You may find that pain medication causes constipation. Drink plenty of fluids and take bulk-forming fiber laxatives available at any drug store, if needed. Walking can also help, but follow the instructions in the next section to be safe.
If you wish to discontinue use of narcotics due to constipation or other reasons, you may also use over the counter extra strength non arthritic Tylenol. Do not exceed more than six 500-mg tablets in 24 hours.
Activities After Surgery
You probably won't feel like running a marathon right after having your spine operation. However, walking is a relatively low impact activity you can do after surgery. Begin slowly and take small, frequent strolls. You may need to use a walker or other assistive device in the beginning for safety reasons.
Gradually increase the distance you walk as you feel more comfortable and steady on your feet. Try to walk one mile a day by six weeks after the date of your procedure.
In terms of activities to avoid, stay away from motions that include bending, lifting, and twisting (also called BLT!), to protect your surgical area. If you need to turn, try to turn your whole body instead of twisting at the waist.
You've probably heard the advice of squatting with your knees rather than bending at the waist, and never is that more important than after having lumbar fusion surgery! Bend at your knees or use a grabbing device to pick items off the floor, if needed. Hold objects close to your body as opposed to outstretching your arms. Do not lift any object that weighs over 10 pounds.
Many patients want to know when they can get back behind the wheel after lumbar spine fusion. Await your surgeon's instructions at your post-operative appointment approximately two weeks after your procedure. Do not drive if you are still taking pain medication, or are feeling weak, having pain, or experiencing numbness or tingling in your lower extremities.
Other Important Tips
After surgery, wear the back brace you brought to hospital when you are up and out of bed. If you twist and turn in your sleep, it may also provide comfort overnight, or use pillows to bolster and support your body. Contact the brace manufacturer with any questions.
If you have questions about when to return to work, talk to your surgeon, who should be happy to provide a note with restrictions, if needed.
Smoking causes delays in recovery, and secondhand smoke is equally dangerous to the healing process. Stop smoking at least two weeks prior to surgery and six weeks after. Lumbar fusion surgery provides a great excuse and opportunity to quit tobacco entirely, but if you choose to continue, talk to your surgeon about when to resume after the operation.
Call your provider if you notice any of the following:
- Extreme redness or swelling at the surgery site
- Excessive drainage from the incision
- A temperature of 101.5 degrees or higher
- Persistent pain that is resistant to medication or rest
- Changes in bowel or bladder function
- Calf pain, redness, warmth or swelling of your calf
- Anything else that causes concern or raises questions
You will likely return to your provider about 10 to 14 days after surgery. If you don't have an appointment when you leave the hospital, contact your provider as soon as possible. Expect to undergo X-rays during your follow-up appointments at the following intervals:
- 10 to 14 days
- Six weeks
- Three months
- Six months
- One year
Don't be alarmed by the X-rays — your doctor just wants to make sure you are healing properly! Follow these general procedures and your surgeon's instructions to ensure that you get back on your feet and return to your normal activities as soon as possible after surgery. Don't be a afraid to contact your providers with any specific questions or concerns. As always, contact 911 if you have an emergency situation.
For general information, you can also read this blog on frequently asked questions about spine surgery.