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Home Care Instructions after Thoracic and Lumbar Anterior/Posterior Spine Fusion Surgery (7025)

Home Care Instructions after Thoracic and Lumbar Anterior/Posterior Spine Fusion Surgery (7025) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Orthopedics

7025







Home Care Instructions after Thoracic and Lumbar
Anterior/Posterior Spine Fusion Surgery


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
listed at the end of this handout.

Activity

You should slowly increase your activity. In most cases common sense will tell
you when you are doing too much. On the other hand, doing too little can delay
the return of your strength and stamina. You may climb stairs. No sports except
the walking program. Begin the walking program once you are home.

Day 1: Walk the length of the hallway at home 3-4 times in the morning and again
in the afternoon or evening.

Day 2-6: Increase the distance you walk by a small amount each day.

Day 7: Walk to the end of the driveway twice a day.

Day 8: Walk a 1/2 block twice a day.

Day 9: Walk 1 block twice a day.

Day 10: Walk 1 ½ blocks twice a day.

After Day 10: Increase the distance you walk as you are able.

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Smoking

We strongly suggest you quit smoking, avoid tobacco products, and second hand
smoke. Smoking will delay bone healing. It is best not to smoke for at least 4-6
months after surgery.

Sitting

You may sit for any length of time based on your comfort level. You should
change your position every 30 minutes.

Sleeping

Sleep either on your back, stomach, or side. You may use pillows for support.
Place pillows behind your knees when lying on your back. Place pillows behind
your back and between your legs when lying on your side.

Bathing

You may shower 5 days after your surgery. No tub baths for 2 weeks.

Driving

Do not drive for 2 weeks or while taking narcotic pain medicine. Do not drive
until your reflexes return to normal. Check with your doctor before driving.

Sexual Activity

No sex for 3 weeks. After 3 weeks, you may resume sexual activity if
comfortable.

Spine Precautions

 Log roll. Logrolling is rolling side to side in bed while keeping your spine
straight.
 No bending at the waist. You may squat with your knees.
 No twisting.
 Do not lift more than 10 lbs (about 1 gallon of milk) for the first 6 weeks.


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Compression Stockings (TEDS)

To improve blood flow and decrease the risk of getting a blood clot, you need to
wear elastic stockings (TEDS) until you are walking and back to your normal
activities. Remove the TEDS 2 times each day for one hour at a time. You should
sleep with them on. You may wash the TEDS with soap and water. Let air dry.

Incision Care

Proper care of the incision helps to prevent infection.
 If the incision is clean and without drainage, you may stop wearing the
dressing after 5 days.
 Change the dressing every other day or as needed.
 Keep the incision clean and dry.
 The incision is 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 take a shower. You may gently remove them
after 10 days.
 Check the incision daily to be sure it is clean and dry.
 Check for redness, swelling, or drainage. Some redness and swelling is
normal.
 A small amount of clear or slightly blood tinged drainage from the
incision is normal.
 Do not wash directly over the incision. Wash around the incision
gently with soap and water and then let air dry.
 Do not use any creams, lotions, ointments, or alcohol near or on the
incision.

Temperature

Take your temperature twice a day for 10 days.

Note
If you had a thoracotomy, a surgical incision of the chest wall between two ribs, it
is important to cough and deep breathe and use the incentive spirometer to help
prevent pneumonia. Please keep doing these breathing exercises for 1-2 weeks
after surgery.

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To cough and deep breathe
1. Place a pillow over your chest to decrease the pain while coughing.
2. Breathe in deeply and slowly through your nose. Hold it for a few seconds.
3. Exhale slowly through the mouth.
4. Repeat twice more.
5. Breathe in again; hold it, and then cough.

To use the incentive spirometer
1. Exhale and place your lips tightly around the mouthpiece.
2. Take a deep breath. Slowly raise the Flow Rate Guide
between the arrows.
3. Hold it. Continue to inhale, keeping the guide as high as
you can for as long as you can, or as directed by your nurse
or respiratory therapist.
4. Remove the mouthpiece and breathe out as usual.
5. Slowly, repeat 10 times each hour while you are awake.

Pain Management

During the healing phase, you may have an increase in pain and/or numbness in the
low back and legs. This is normal and is caused by tissue swelling and recovery of
nerves in your low back. To reduce the pain, there are many options to try.

ξ Ice the incision area for 15 - 20 minutes as often as needed. Do not put the
ice directly on the skin. Use a pre-made ice pack or put ice in a plastic bag
and wrap in a towel before you use it.
ξ Do not sit more than 15-30 minutes at a time for the next 48 hours.
ξ Reduce your activity for the next 48 hours (i.e. walking).

You may also need to use pain medicine. If needed, take it as prescribed.

ξ Narcotics: Do not increase the prescribed dose without checking with your
doctor or nurse.

ξ Tylenol® (acetaminophen): You may take up to 4000 milligrams per day.
Percocet® and Vicodin® also contain Tylenol®. If you have liver disease, do
not take Tylenol® without checking with your doctor.

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ξ Do not take Non-Steroidal Anti-Inflammatory drugs (NSAIDs) (i.e.,
Ibuprofen, Motrin , Advil , Aleve , etc) for 3 months. Do not take Aspirin
for 3 months unless prescribed for a heart problem by a cardiologist or your
local doctor. These medicines delay bone healing.

If you are not sure about a medicine, please call the Spine Clinic.

Constipation

The combination of surgery, narcotic pain medicine, decreased activity level and a
change in your diet, can play a role in getting constipated. It is common to have a
problem with your bowels after surgery. Please see Health Facts for You
Constipation from Opioids (Narcotics) found in the Post-Operative
Orthopedic Spine Surgery Packet.

When to Call the Doctor

ξ Increased pain, swelling, or redness in or around the incision site.
ξ Sudden increase in pain or pain not relieved by medicine.
ξ An increase in the amount of drainage, change in the color of drainage, or
any odor from the incision. Be ready to describe what the drainage looks
like, how it smells, and how much there is.
ξ A temperature above 100.5ºF or 38.1°C for 24 hours.
ξ A “new” chest pain, “new” problem with breathing.
ξ Redness, warmth, or tenderness in the back of the calf of your leg(s).
ξ A persistent headache that is different when sitting or lying down.
ξ Problems urinating or having control of your bladder or bowel movements.

Return to Work

When you return to work will depend on your recovery and the type of work you
do. You must discuss this with your doctor.

Refills

The Spine Clinic staff will be working with you to balance pain medicine, pain
management, and activity. The goal is to taper you off of your pain medicine by 6
weeks after surgery. If you need a refill on your pain medicine, call the Spine

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Clinic at (608) 265-3207, Monday through Friday, 8:00 a.m. to 4:00 p.m. and ask
for the nurse. Please call when you have a 2 to 3 day supply left of your
medicine. Be ready to give the name and phone number of the drugstore where
you want to pick up a refill.

Future Clinic visits

The nursing staff will help you schedule your first clinic visit in 4-6 weeks. All
other clinic visits will be as needed.

Phone Numbers

If you have questions or concerns, please call the Spine Clinic.
Monday through Friday between 8:00 AM and 5:00 PM at (608) 265-3207.

Nights and Weekends, call the paging operator at (608) 262-0486. If you live out
of the area, call 1(800) 323-8942. Ask for the “orthopedic resident on call”. Leave
your name and phone number with the area code. The doctor will call you back.

















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 ©9/2014. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7025.