Generalized Post-Operative Instructions

Pain

It is completely normal to have Post-operative pain, muscle spasm, numbness or tingling. These symptoms should gradually resolve as your muscles and nerves heal. Numbness and tingling are usually the last symptoms to resolve, since nerves take the longest to heal (weeks to months). Gentle Ice packs for the first 5 days to the incision site will help decrease swelling and pain. It is common to have a sore throat after endotracheal intubation. This tenderness should resolve in a few days.

*One rare complication of surgery is internal bleeding. One of the complications of this rare occurrence is compression or increased pressure on your spinal cord. This will cause your symptoms to drastically worsen. This may cause paralysis and is life and limb threatening. Go to an Emergency Room immediately for evaluation.

Call Our Office if you have:

- Fever of 101.5 degrees or higherDifficulty Breathing or Chest Pain

- Postural HeadacheA sudden increase in severe pain, numbness or weakness

- Loss of bowel or bladder control - Drainage from your incision (other than occasional spotting of blood)

If the office is closed and you cannot reach an On-Call Physician, go to the nearest Emergency Room for Evaluation.

General Hygiene

- Fever of 101.5 degrees or higherDifficulty Breathing or Chest Pain

- Postural HeadacheA sudden increase in severe pain, numbness or weakness

- Loss of bowel or bladder control - Drainage from your incision (other than occasional spotting of blood)

If the office is closed and you cannot reach an On-Call Physician, go to the nearest Emergency Room for Evaluation.

Incision Site

Keep Incision covered with a bandage for the first 24–48 hours after surgery. After this time, your incision will need to be looked at daily. Keeping the incision as dry as possible will help your incision stay clean and free of infection. Gently Pat dry the incision, do not rub or add lotion/powder. Let Incision air dry for 1 hour three times daily. It is important to keep the incision as dry as possible. The dryer your skin, the less likely you are of developing an infection. Some redness around the incision site is normal and should diminish with time

Indications for a bacterial infection include:

Fever over 101.5 degreesRapidly increasing redness around incision site

Foul odor or puss filled discharge from incision site

Incision Closure

Sutures: Most of the time, your incision will be closed with stitches below the surface of the skin. These internal stitches will dissolve on their own, usually within 2–4 weeks. Don’t be alarmed if they fall out on their own. If your incision oozes small amounts of blood after surgery, don’t be alarmed. Keep initial dressing in place and reinforce the dressing with new gauze. Change this dressing every 2 days or until your incision is dry. You will also notice small sterile steri-stitches over the incision site as well. These will loosen and fall off in 5–10 days. Once off the skin, you may keep incision uncovered and dry.

Staples: Keep your incision dry, do not attempt to remove the staples. These will be removed at your 2 week post–op appointment.

Diet

Staples: Keep your incision dry, do not attempt to remove the staples. These will be removed at your 2 week post–op appointment.

Constipation

We encourage a balanced diet full of fiber to decrease the possibility of constipation. Soft or liquid diet is best tolerated until it is easy to swallow. Over the counter products such as prune juice or Metamucil will help. Use as directed. Drink twice as many fluids as you did prior to surgery, or 6–8 glasses of water daily. A multi-vitamin that includes calcium and iron should be taken as well.

Return To Work

Returning to work varies with occupation and the type of surgery you had performed. This will be discussed with you at your Post-Operative visit.

Follow-up Appointment

Returning to work varies with occupation and the type of surgery you had performed. This will be discussed with you at your Post-Operative visit.

Medication

All of your medications may be refilled during normal office hours (9am–5pm, M–F). However, your medication cannot be refilled on the weekend or after office hours.

Medrol dose pack: If you were told to take oral steroids, make sure you have a prescription before leaving the hospital and take as directed. Occasionally, steroids can increase swelling and irritation to the incision site. Also they may increase your blood glucose levels so if you are diabetic, check your blood sugars religiously.Pain Medication: Make sure you have a prescription before leaving the hospital and take as directed. Narcotic medication has been shown to be addictive and can lead to tolerance and loss of effectiveness if taken chronically. Advanced Neurosurgery encourages you to be proactive in weaning yourself off of narcotic medication and use it as needed. Almost all pain medication will make you constipated so increase your fiber intake and stay hydrated. These medications will make you drowsy SO: Don’t operate machinery, drive, or drink alcoholic beverages while on your pain medication.

Muscle Relaxants: Make sure you have a prescription before leaving the hospital and take as directed. These medications will make you drowsy SO: Don’t operate machinery, drive, or drink alcoholic beverages while on your pain medication.

Medication to Avoid if you have undergone SPINAL FUSION:

- Any Non-Steroidal Anti-Inflammatory (NSIAD) - Aleive

- Celebrex - Feldene

- Lodine - Motrin/Ibuprofen

- OrudisVioxx

- Steroids (unless approved by Dr. Song) *Does not include Tylenol

Smoking:

If you use tobacco products, it is in your best interest to stop. Nicotine constricts blood vessels and decreases blood flow to your operative site. This decreases your bodies’ ability to heal and increases your chances of having a poor surgical outcome and chronic pain.

Back Braces:

Hard Cervical Collar:

We know these braces are uncomfortable, but unfortunately they need to be worn when out of bed. Basically wherever you go, the brace must follow you there. The only time the brace may be removed during the day is to clean and dry your incision site. This is necessary to decrease the risk of infection. You may exercise, but start slow and gradually increase your activity. During your first week post-operatively, do not sit for more than 10 minutes at a time. Sitting puts more pressure on your back than does standing or walking. After your first office visit, you may increase your sitting time.

Soft Cervical Collar:

Use as directed by Dr. Song or as needed.

Posterior Cervical Discectomy

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Posterior Cervical Laminectomy

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Craniotomy

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Advanced Neurosurgery

✆ Phone (appointments): 775-312-8120

✆ Phone (general inquiries): 775-323-6100

Locations:
10791 Double R Blvd., Reno, NV 89521
1470 Medical Parkway, Suite 240, Carson City, NV 89703

Fax Numbers:
775-323-6118

775-996-7316

Generalized Post-Operative Instructions

Pain

Call Our Office if you have:

General Hygiene

Incision Site

Indications for a bacterial infection include:

Incision Closure

Diet

Constipation

Return To Work

Follow-up Appointment

Medication

Medication to Avoid if you have undergone SPINAL FUSION:

Smoking:

Back Braces:

Hard Cervical Collar:

Soft Cervical Collar:

General Pre-Operative

General Post-Operative

Lumbar Discectomy

Lumbar Decompression

Lumbar Fusion

Lumbar Laminectomy

Lumbar Laminectomy with Fusion

Anterior Cervical Discectomywith Fusion

Anterior Cervical Corpectomywith Fusion

Posterior Cervical Discectomy

Posterior Cervical Laminectomy

Craniotomy