Lumbar Spinal Fusion
Table of Contents
Lumbar Spinal Fusion
Most Common Causes of Lumbar Back Pain
Your Visit With The Surgeon
Getting Yourself Ready For Surgery
Understanding Back Precautions
Making Arrangements For Surgery
Your Hospital Visit
Lumbar Spinal Fusion Surgery
Recovery At Home
When To Call Your Surgeon
Long Term Care For Your Back
Most people are admitted to the hospital the morning of surgery. Follow the instructions you were given during your pre-admission visit. The hospital will have the results of your pre-admission tests and all forms that you have completed.
The Surgical Preparation Area
At the hospital, someone will take you to a room or the surgical preparation area. A nurse will help you get ready for surgery and answer questions for you and your family. You will change into a hospital gown and lie on a hospital bed until time for you to be taken to the operating room. Your surgeon and the anesthesiologist may come by and see you while you are waiting for surgery. You will be able to visit with your family before surgery. When you go to surgery, your family will be shown to a waiting area.
You may be given medicine to make you a little drowsy and relaxed just before you are taken to the operating room. Before you go to surgery, an intravenous tube (IV) will be placed in your arm or the back of your hand. This tube supplies your body with needed medicines and fluids. Also, you may begin receiving anesthesia through this tube.
Your surgeon may order special “leggings” for you to wear during and right after surgery. These leggings help your blood circulation. They may be put on while you are in the holding area, or once you get to the operating room. The leggings are made of air pockets that slowly inflate and deflate, and feel like a leg massage. Your surgeon may have you wear them after surgery until you are up and walking around.
The Operating Room
You may not remember going into the operating room. Once there, electrodes (wires) and other tubes will be attached to or placed in your body. These will monitor your body’s functions, remove excess fluid, and help you breathe during surgery. Your back or abdomen will be scrubbed with a germ killing soap. When everything is ready, the surgeon will begin your surgery.
The Recovery Room
Your surgery will take about 3 to 6 hours. You will be in the recovery room for another hour or 2 for a total of 4 to 8 hours for surgery and recovery. Someone will update your family during your surgery and when you reach the recovery room. When your surgery is over, your surgeon will talk with your family about your surgery.
In the recovery room, you will gradually wake up. You may feel groggy from the anesthesia. You will hear sounds from the equipment around you and your nurse telling you surgery is over. You will still have tubes and monitors attached. The monitors provide the recovery room nurses with data on how your body is recovering. You may have a sore throat from the breathing tube. It is important to tell your nurse if you feel numbness, tingling, or pain in your feet and legs. The recovery room nurses will keep a close watch on your recovery and do what is needed to help keep you comfortable.
You will be asked to “pedal” your feet up and down. This pedaling exercise will help blood circulation. You may also feel the special “air leggings” on your legs. If you did not have them on when you went into the operating room, they may have been put on while you were there.
You may have a cooling blanket on your back. This blanket will help reduce pain and swelling along your incision. You may also have a drainage tube coming from your incision that drains off excess fluid from around your incision.
Pain Control After Surgery
You can expect to have some pain after surgery. How much pain and how long it will last depends on the type of surgery you had. Also, everyone’s pain level is different. If you need pain medicine, don’t wait too long to ask for it. Pain medicine can be given to you in different ways: by mouth (pills), into your IV, or a shot. How you receive medicine will depend on your surgery and how much pain you are having.
You may have a PCA pump for the first few days after surgery. PCA means “patient controlled analgesia”. Your nurse will show you how to push the button and give yourself pain medicine. The pump will be set according to your anesthesiologist’s instructions. Only a limited amount of medicine is released each time you push the button. This keeps you from getting too much medicine. You are the only person who should push this button to receive pain medicine. Do not allow anyone else to push the button for you for any reason!
Taking Part In Your Recovery
Patients generally stay in the hospital for 3-4 days. Elderly or debilitated patients may have a short stay in a rehab unit. As you become more active, you will become more involved in your recovery — even while you are in the hospital. You can:
• eat right (plenty of fiber and protein) and drink plenty of fluids
• keep your lungs free of fluid by doing your deep breathing and huffing exercises
• get out of bed as soon as you can so your muscles stay strong; start slowly sitting on the side of the bed, then a chair, then short walks, then longer walks
• wear elastic or support stockings if your surgeon has ordered them
• wear your brace when you should
When getting out of bed, “logroll” onto your side and scoot to the edge of the bed using your hips and legs. Then, push up to a sitting position with your elbows, arms, and hands while letting your feet and legs drop over the side of the bed.
It is important to avoid breathing problems after surgery. Because of anesthesia and your limited movement right after surgery, fluid can build up in your lungs. This fluid can lead to pneumonia which will keep you in the hospital longer. Every hour you will need to take deep breaths and “huff” several times in a row. A “huff” is a short, forceful exhalation of breath. Also, you may be shown how to breathe deeply using an incentive spirometer.
Coughing should be avoided, but, this is not always possible. If you must cough, “hug” a pillow tightly against your stomach to lesson the force of the cough on your back.
You will be asked to pedal your feet up and down, and tighten your thigh and buttocks muscles while you are lying down. Do these exercises ten times each hour while you are awake. These bed exercises will help blood circulation and prevent blood clots.