Spine / Back Surgery

Types of Back Surgery

There are different types of back surgery depending on your problem; therefore, some of the following information may not pertain to your specific case.

Decompression/Laminectomy is a procedure to remove the bone that is putting pressure on nerves, which is usually the cause of leg symptoms.

Microscopic Discectomy is done to remove the herniated portion of the disc from the spinal column.

Fusion immobilizes a segment of your spine due to spondylolisthesis, spondylolysis and/or degenerative disc disease (DDD).

• Transforaminal Lumbar Interbody Fusion (TLIF) is done through an incision on the low back, immobilizing the vertebral disc space(s) in question from any further movement.
• Posterior Spinal Fusion is done through an incision on the back, immobilizing the vertebral disc space(s) in question from any further movement.
• Anterior Lumbar Interbody Fusion (ALIF) is done through an incision in the front of the abdomen, immobilizing the vertebral disc space(s) in question from any further movement.

Disc Arthroplasty replaces the disc between two vertebral bodies to maintain motion at that segment.

Kyphoplasty is a minimally invasive procedure done to treat a fracture of the vertebral body. A bone cement is used to restore the strength and height of the vertebral body.

Dorsal Column Stimulator is a type of implantable device that is used to send electrical signals to select areas of the spinal cord.

Preparing for Surgery

The doctor may request medical clearance from your family doctor in order to make sure any medical conditions you have will not affect your ability to tolerate surgery. If you take insulin, ask your family doctor how to take this medicine on the day of surgery.

All medications having blood thinning tendencies, prescribed or over-the-counter, must be stopped five days prior to surgery. Medications with blood thinning tendencies include:

• Aspirin
• Vitamin E
• Fish oil/Omega 3/Lovaza/Krill oil
• Celebrex
• Relafen/Nabumetone
• Lodine/Etodolac
• Motrin/Ibuprofen
• Daypro/Oxaprozin
• Mobic/Meloxicam
• Naproxen/Naprosyn/Aleve
• Disalcid/Salsalate
• Feldene/Piroxicam
• Arthrotec/Voltaren/Cataflam
• Diclofenac
• Toradol/Ketorolac Tromethamine
• Vimovo

If you take any of the following prescription medicines you must check with the doctor monitoring this medicine to be sure it is okay to stop:

• Plavix/Clopidogrel
• Coumadin/Warfarin
• Pradaxa/Dabigatran
• Xarelto/Rivaroxaban
• Eliquis/Apixabin
• Pletal/Cilostazol
• Persantine/Dipyridamole
• Ticlid/Ticlopidine
• Aggrenox/Aspirin/Dipyridamole
• Lovenox
• Arixtra/Fondaparinux
• Effient/Prasugrel

Notify us immediately if at any time before your surgery you have any symptoms of an infection (for example, a urinary tract or sinus infection), especially the week before your surgery.

If you smoke, your doctor may require you to stop 4-6 weeks before doing your surgery and for 12 weeks after your surgery. The nicotine dramatically slows and/or hinders the healing process by 40% per level fused. The doctor may order a blood draw or urine test to check your nicotine level.

A back brace is usually not necessary unless you have severe osteoporosis or you ignore your restrictions after surgery.

You must not eat or drink anything after midnight the night before your surgery!

What to Expect After Surgery/Recovery Period

A discectomy, laminectomy, permanent DCS placement and kyphoplasty may be outpatient or involve an overnight stay. A lumbar fusion involves a 1-2 day stay. Staff will assist you in walking a short distance approximately 6 hours after surgery.

Pain management during your hospital stay may be by intravenous patient-controlled anesthesia (PCA), injections or by oral pain medications. We recommend you switch to oral pain medications as soon as you are comfortable.

After a fusion surgery, you will find a drain coming from your back lying next to you in bed. This will relieve any fluid accumulation from the surgical area. If you are sent home with a drain you will have to return to our office the following day to have it removed.

Do not be discouraged if you have some of the same pain as before your surgery. You have had pressure on the nerves for some time and it can take 12-18 months for the nerves to recover. You may find that your energy level is quite low after surgery (even the trip home from the hospital may wear you out).

The hospital discharge planner or the social services department will help you arrange for assistance or assistive devices at home.

Patient Education Sheets

For additional information about treatment, we have included this complete patient eduction sheet as a pdf to view, download and print: