Post Operative Cervical Surgery Instructions

Today you are having an anterior cervical discectomy and fusion or other cervical
surgery. Most cervical surgeries take about an hour to an hour and a half total
time. Post operatively you will wake up in the recovery room staying for about 45
minutes to an hour. Then you will either go to our same day area or to the floor
where the staff will get you up and moving.

If you have more than one level performed we will often use a drain which you
will go home with from the hospital. The nursing staff will teach you drain care and
will make arrangements for you to come to the office for the drain to be removed.
The drain is important post operatively, as it will help you with pain control and
also help with swallowing.

Post operatively you should expect to have some issues with neck pain both at the
surgery site and the back of your neck. You will also have some swallowing
difficulties. The swallowing difficulties are normal and usually resolve within 2 to 3
weeks time after surgery. We advise patients to ice their neck frequently post
operatively. You cannot use ice too much but 15 minutes every 2 hours at the
surgery site as well as the back of the neck is expected. This will cut down on your
post operative pain and help with swallowing and decrease any swelling. Swallowing is
difficult after many of the surgical procedures, and we advise you to follow a soft diet
including but not limited to yogurt, pudding, scrambled eggs, mashed potatoes, and
avoid harder foods such as chips, fried foods or steak. We also advise patients to
have on hand Ensure or Boost shakes as that gives good nutrition in a liquid form.

Other methods to help with swallowing difficulty would include the use of
chloraseptic spray especially right before a meal. If there is a lot of upper airway
congestion then the use of Mucinex every 12 hours over the counter is also helpful.
We allow patients to shower starting the day after surgery. If you have a drain in
place we do not like the shower to spray directly on the drain. When you finish
your shower you should then pat the area dry and once it is completely dry apply a
new dressing.

Change the dressing on a daily basis for 3 post operative days. Then after that
you can leave the wound open to air.

We provide all patients with a soft cervical collar. For patients who have a single
level fusion the cervical collar can be worn for comfort at their discretion. It is
not mandatory. For patients that have 2 or more levels done in the cervical spine
we generally provide an Aspen collar. We ask that you place the Aspen collar on
your neck upon waking in the morning and wear it throughout the day. You can
remove the Aspen collar to shower, eat, and when you are icing your neck. Many
patients like to wear the soft collar at night when they rest as it gives them some
comfort and support of the head and neck but that is not absolutely necessary.

We advise patients to get back to your normal state of health and activity as quickly
as possible after surgery. We are basically doing surgery on your neck, not your
arms or your legs so you should be using them as much as you possibly can. In
general you can raise your arms above your head to work on some stretching
exercises as well as range of motion of your shoulders. The more you can move the
upper body extremities the less tension and muscle spasms you will have in the
back of your neck. As you return to your normal activities your pain level will drop
dramatically.

Patients usually followup in the office between 7 and 10 days post operatively for
recheck of your neck and x-rays. At that point we will go over the x-rays with you in
detail, explain the procedure, and discuss further care. Patients often ask when they
can drive post operatively. We allow driving once you are off of pain medication. If
you have been given a hard cervical collar it is illegal to drive in the collar. We
advise you to remove the collar, drive, and then reapply the collar.

After lumbar surgery of any kind it is very important for the patient to return back to
a normal level of activity. We encourage you to get out and walk as much as
possible. We like to see patients actively walking outside for 30 minutes a day at a
minimum. As the healing process continues the duration of time should also
increase. After any lumbar surgery a patient is expected to have lumbar back pain
however with activity that will improve. We encourage patients to avoid bending
forward at the waist and to use proper body mechanics when lifting any objects
using the knees to squat down, lift the object, and then carry it close to the body.
After lumbar surgery we limit lifting to 10 pounds the first week. Once you have
been re evaluated in the office the lifting limit will increase to 20 pounds.

Post operatively the patients will wake up in the recovery room. You are usually
there for about 45 minutes to an hour. At that point you will be moved either to our
same day area or to the floor where the staff will get you up and moving. With
most lumbar procedures once you are active and your pain is controlled you be
discharged to home.

Most patients will have a dressing on their back. We ask that the dressing be
changed on a daily basis for 5 days. If any drainage persists please contact the
office.

We allow patients to start showering the day after surgery. It is fine for water to run
over the incision area. For patients who have a lumbar drain in place we advise
you to keep that area dry when showering. Once the drain is removed you can
resume showering as normal.

If a lumbar fusion is performed you will be fitted with a lumbar back brace to wear
post operatively. We advise patients to wear the brace when up and active and when
walking more than 5 minutes. You do not have to wear the brace in the car, while
sitting or while laying down. Some patients will find comfort wearing the brace when
in a sitting position and that is acceptable.

You will be prescribed pain medication to take post operatively as well as a muscle
relaxant medication that we advise you to take at night to help with rest.
Most patients have a difficult time finding a position of comfort after back surgery
when trying to lay down to rest. We allow you to lay on your side or back while
sleeping but we do ask you to avoid sleeping on your stomach. Some patients
prefer to sleep in a recliner post operatively and that is acceptable until they can lay
flat in the bed.

Patients are allowed to gently twist and turn post operatively. This will not harm
you as far as the surgical procedure.

You will be able to drive once you are off pain medication and feel that you have good
control of your lower extremities.

You will follow-up in the office typically between 7 and 10 days post operatively. Any
post operative x-rays will be explained to you and the surgery will be reviewed in
detail. We will always be happy to answer any questions in the post operative
phase.

We typically will send you home from the hospital with 2 different medications. A
muscle relaxer which you will take a night before you go to bed to help with rest. We also
will prescribe post operative pain medication and will go over the dosing of that
medication with you while in the hospital. You are advised to drink plenty of
fluids.

We will typically go over all these instructions with you in the hospital both before
and after surgery. We will be happy to answer any of your questions. If you have
any issues in the post operative phase call the main office phone number and one of
our staff will return your call and answer any questions.