PROCEDURES EXPLAINEDOutpatient Fusion Surgery
Outpatient spinal fusions are a relative newcomer in spinal surgery, but modern techniques have made for an extremely streamlined operative process. The goal of spinal fusion is to restore stability to the vertebral column, by permanently fusing two or more vertebrae into a single structure. Not all patients will be candidates for outpatient surgery, but it is an excellent option for those that are.
What to Expect
- You will have an IV placed in your arm or hand for the delivery of anesthetic to put you into a deep sleep and prevent pain during your surgery.
- Your surgical team will usually consist of a vascular surgeon as well as an orthopedic or neurosurgeon. There are several possible procedures, but spinal fusion is commonly accessed from the front, side, or back.
- In posterior spinal fusion you will lie on your stomach and the surgeon will make the initial incision along the spine. In the anterior approach, the patient will lie on their back or side, a lung may be deflated, and a rib may be removed to access the spine.
- The surgeon will attach metal rods to each side of the patient’s spine using hooks or screws attached to the vertebrae.
- The diseased disc or discs are removed, and the area prepped for grafting.
- A bone graft is then used to fuse the vertebrae, which may be from the patient’s body, a bone bank, or synthetic. The rods ensure the spine remains aligned throughout the healing process.
- After the procedure is complete, the surgeon will restore all structures that were moved for the operation back to their normal locations.
- The incision is then closed, and steri-strips may be placed to facilitate healing.
- You will then be taken to a recovery area for close monitoring until you awaken. You will still have your IV, and may have a catheter to help facilitate urination while you recover. You may also have a sore throat from intubation. When you are fully alert and awake, you will then be returned to your hospital room.
Experiencing Symptoms of Outpatient Fusion Surgery?
Common Risks and/or Frequently Asked Questions
Bleeding
Blood clots
Nerve damage
Return of symptoms
Infection
Post Procedural Instructions
- Activity Restriction
- Pain Management
- Incision Care
- Call if
- Desk jobs may be returned to in about 2 weeks, but others may require 4 weeks or more
- Do not drive or operate heavy machinery while taking narcotics
- Do not try to lift more than 10 pounds
- Do not smoke
- Walk as often as is comfortable on non-slippery surfaces
- Be mindful of body motion practices, as discussed with your physical therapist
- Post-procedural pain may last days to weeks as the inflammation subsides
- Do NOT take NSAIDs in the first few months following surgery, as they can interfere with the bone healing process
- Take your prescribed pain medication as recommended, and inform your care team if relief is inadequate. It is normal to feel some degree of pain during the recovery process, but it should not be excruciating.
- Unless otherwise stated, your incisions are most likely sutured from the inside.
- Dressings may be removed about 48 hours after surgery, and incisions should be washed with soap and water
- Do NOT soak the incision site, baths, hot tubs, and pools should be avoided for 2-3 weeks until the wounds have fully healed
- Sunblock with SPF 30 or greater may be used to protect healing skin from discoloration, as new skin will lack the sun protectant pigment melanin
- Fever of 101.5 F or greater
- Redness, swelling, warmth around the incision site
- New neurological symptoms, such as weakness or loss of sensation that was not present before
- Loss of bowel or bladder control that is new
- Severe Pain
- Difficulty swallowing or speaking
- Severe Headaches
- Calf Swelling, as this may be a sign of thrombosis
- Chest pain, difficulty breathing, or cough
Common
Recovery Timeline
The benefit of outpatient surgery is that you may return home within hours of completing your surgery.
The first week requires plenty of rest. Even so, you may be standing as early as the first day after surgery. By the end of the first week, tasks that do not require you to bend or lift should be manageable.
During the first few weeks, you will need help with daily chores such as cooking and cleaning from friends and family while you focus on letting your body heal from operation.
As you approach the month mark from the day of surgery, most patients are feeling more energetic. Adults start returning to work, while children and adolescents begin returning to school. Pain medications will usually be unnecessary by this point.
Despite feeling better, patients must still be careful to avoid overexertion.
At 6 weeks, your condition will be evaluated during a follow-up visit to evaluate if you can take on more strenuous activities.
By 12 weeks, x-rays will be taken to check on progress. If everything is as it should be, most patients are able to resume most normal activities, with the exception of a few potentially damaging activities requiring much spinal flexibility.
A final check-in will be made typically between 6 and 12 months of surgery, at which point patients can resume all activities once permitted by their surgeon.
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