Clinical Hub,Patient Education,Health and Nutrition Facts For You,Orthopedics

Home Care After Anterior Lumbar Interbody Fusion (4957)

Home Care After Anterior Lumbar Interbody Fusion (4957) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Orthopedics


Home Care After
Anterior Lumbar Interbody Fusion

Surgery Date: _____________________________________________
Doctor: ___________________________________________________

This handout will review the care you need to follow once you are home. If you have any
questions or concerns, please ask your nurse or doctor. Our staff is here to help you. If you have
questions after you are at home, please call the numbers at the end of this handout.

The anterior fusion method can be done either as an outpatient (home the same day as surgery) or
as an inpatient with a one-night hospital stay. The decision will be based on how you are doing
after the surgery.

This is major surgery and you need to give your body time to heal. Below are instructions that
you should follow until your first follow-up visit.

Sitting: You can sit for any length of time based on your comfort level. You should
change your position at least every 30-45 minutes. If you become
uncomfortable change your position and activity.

Sleeping: You may sleep on your back, stomach, or side. You may also use pillows for
support when lying on your side. Place pillows behind your back and between
your legs. When you lie on your back, place pillows under your legs.

Bathing: You may shower in 5 days. Avoid tub baths for the first 2 weeks.

Driving: Do not drive for 2 weeks or while you are taking narcotic pain medicine. You
may be a passenger.

Sexual Activity: After 2 weeks, you may resume sexual activity when comfortable.

Restrictions: Do not lift more than 10 pounds (about 1 gallon of milk) for the first 6 weeks.
Do not bend or twist at the waist, but you may squat with your knees. No
sports until your first follow-up visit other than the walking program.

Walking: You no longer need to wear the TED stocking (heavy white elastic stocking)
once you return home as long as you are walking frequently. A walking
program should begin 2 to 3 days after you are home and continue daily. In
most cases, the goal is to walk at least a mile by the time you return to your
first follow up visit You may climb stairs.

Walking Program
Your program will be designed just for you and may not be exactly the same as the suggested
program below.

Day 1: Walk the length of the hallway at home 3-4 times, or walk to the end of the driveway and
back once in the morning and again in the afternoon or evening.

Day 2: Walk 1/2 block or the equivalent of a 1/2 block indoors once in the morning and again in
the afternoon or evening.

Day 3: Walk 1 block in the morning and 1 block again in the afternoon or evening.

Day 4: Walk 2 blocks in the morning and 2 blocks again in the afternoon or evening.

Day 5: Walk 3 blocks in the morning and 3 blocks again in the afternoon or evening.

Continue increasing the distance you walk, as you are able. Let your comfort be your guide to
how much you can do.

Return to Work
Your return to work will depend on how you recover and the type of work you do. If you have to
lift more than 10 lbs, you will not be able to return for 6-12 weeks. If you lift less than 10 lbs,
you could return to work in 2 weeks. You must discuss this with your doctor.

Pain Control
While you are healing, you may notice some pain, numbness, tingling, or weakness in your back
or legs. You may try some of these options to help manage your pain.

Ice Method: First, use ice and try to decrease your activity for 1-2 days. Ice the area for 20
minutes every hour for 4 hours in a row (especially in the evening). Use a ready-
made ice pack or put ice in a plastic bag and then wrap the bag in a towel before
you use it. Do not put the ice directly on your skin.

Pain Relief: You may also need to use pain medicine. If needed, take it as prescribed.
ξ Narcotics: Do not increase the dose without checking with your doctor or nurse.

ξ Neurontin®/Gabapentin: If you have been taking these before surgery, you should keep
taking them unless you have been given other instructions.

ξ Tylenol® (acetaminophen): You may take up to 3000 milligrams per day. Percocet® and
Vicodin® also contain Tylenol®. If you have liver disease, do not take Tylenol® without
checking with your doctor.

ξ Do not take anti-inflammatory medicine (examples include Aleve, Advil, Motrin,
Naproxen, Ibuprofen) for 3 months after surgery

ξ After 3 months you may use anti-inflammatory drugs ibuprofen, Motrin , Advil ,
Aleve , etc. These may be used if you do not have stomach or peptic ulcer disease,
kidney/liver disease, or bleeding problems. Do not take if you have heart disease or
high blood pressure.

Refills: If you need a refill on your pain medicine, call the Spine Clinic, Monday through Friday
between 8:00 a.m. to 4:00 p.m. and ask for the nursing staff. Please call when you have at least a
3-4 day supply left of your pain medication. Be ready to give the name, address, and phone
number of the pharmacy where you will pick up the refill.

The goal is to taper you off your pain medicine by 4-6 weeks after surgery.

Narcotic pain medicine may cause constipation. Eat plenty of foods with roughage (bran, oats,
fruit, and applesauce) and drink a lot of fluids (juice, prune juice, water) to prevent constipation.
Your walking program will also help.

After anterior surgery, you may have a feeling of abdominal discomfort. Abdominal discomfort
is not serious and most often goes away within 24-48 hours. You may have less discomfort if

ξ Walk around the house.
ξ Lie on your back with your feet up on several pillows (above the level of your chest).
ξ Gently rub your abdomen.

Males may experience scrotal swelling or bruising, this is normal. To help with this, apply a cold
compress, and lie flat with legs elevated. If there is still abdominal discomfort for more than
24-48 hours, contact the Spine Clinic

Incision Care
Proper care of the incision helps to prevent infection.
ξ If the incision is clean and without drainage, you may stop wearing the dressing after 5
ξ Keep the incision clean and dry.
ξ The incision has been closed with sutures under the skin and covered with steri-strips
(small pieces of tape) on the skin. These will slowly peel off as they get wet when you
shower, if they are not off in 7-10 days, gently peel them off.
ξ Check the incision daily to be sure it is clean and dry, change the dressing every other day
or as needed.
ξ Check for redness, swelling or drainage. Some redness and swelling is normal.
ξ A small amount of clear or slightly blood-tinged drainage from the incision is normal.
ξ Do not wash directly over the incision. Wash around the incision gently with soap and
water and then let air dry.
ξ Do not use any creams, lotions, ointments, or alcohol near or on the incision.

When to Call
ξ If you have a temperature above 100.5 θF (38.1 θC) for two readings taken four hours apart
ξ Drainage from your incision
ξ An increase in pain, redness, and/or swelling by your incision
ξ Difficulty urinating or controlling your bowel movements

Future Visits
Your first post-operative visit will be 4-6 weeks after surgery.

Phone Numbers

Spine Clinic: (608) 265-3207 Monday-Friday 8:00 a.m. - 5:00 p.m.

On nights, weekends, and holidays, this number will give you the paging operator. Ask for the
orthopedic resident on call. Leave your name and phone number with area code. The doctor will
call you back.

For patients who live out of the area, please call: 1-800-323-8942.

Your health care team may have given you this information as part of your care. If so, please use it and call if you have
any questions. If this information was not given to you as part of your care, please check with your doctor. This is not
medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each person’s health
needs are different, you should talk with your doctor or others on your health care team when using this information. If
you have an emergency, please call 911. Copyright 4/2015 University of Wisconsin Hospitals and Clinics Authority. All
rights reserved. Produced by the Department of Nursing. HF#4957