For the most part, yes. However, if you have diabetes, hold your medications when you are fasting prior to surgery. We will do our best to schedule your surgery earlier in the day to avoid problems with your diabetes from not eating or taking your medications.
At your pre-op appointment, we will provide you with a list of medications that may increase your risk of bleeding; these medications must be stopped prior to surgery. If you are taking NSAIDs such as ibuprofen, you need to stop these medications 10 days prior to surgery. For those patients who take Warfarin (Coumadin), we will have you undergo a protocol that may involve temporarily switching you to Lovenox or the equivalent heparin medication
To optimize your safety and minimize medical risk factors prior to surgery, a consultation with an internal medicine specialist is a mandatory part of our preoperative protocol. While you are hospitalized after surgery, the hospital-based medicine specialist will make rounds daily. These physicians are the co-admitting physicians during your postoperative stay. For continuity of care, we prefer that they meet you ahead of your admission date so that they are familiar with your medical history and risk factors ahead of time. For surgeries occurring in the outpatient surgery center, you may ask your primary care provider to perform the pre-op medical clearance. Copies of documents such as the operative report and discharge summary will be automatically provided to your primary care doctor by our office staff.
Please bring your most updated medication list and any lab or test results that were done with your internal medicine consultation. Have a list of questions about the surgery to help focus our discussion and make the appointment flow more efficiently. The surgery consent will be completed at this visit.
At the end of your pre-op appointment, you will be given a prescription for your postoperative pain medications so that they can be filled prior to your hospital admission. That way they will be ready for you at home after your surgery.
We will assist you in setting up your appointment. Typically, we see patients 7-10 days after surgery. For patients who have anterior cervical discectomy and fusion procedures and those where staples are used for skin closure (rarely done), we see these patients 14 days after surgery
At this time, we are not a proponent of laser spine surgery as the current application of a laser with spine surgery is merely as a cutting device. This may change in the future as new technology is developed. But at this point, in our opinion, the use of a laser is intended more as a marketing approach to attract patients to a surgery that is not really different from traditional spine surgery.
New “minimally invasive spine surgery” approaches used by spine surgeons can now shorten the incision, lessen time in the hospital, and speed the return to activity with a less painful recovery.
The real area of concern about laser spine surgery, in our opinion, is that the ads encourage people to jump into laser spine surgery when they may not need surgery in the first place.
Usually, showers are allowed within 72 hours after surgery. If the incision is not dry or still oozing, then showers should be delayed until the site is dry. Submersion in baths, hot tubs, swimming pools, oceans, or lakes should NOT occur until cleared by Dr. Radcliff.
Depending on the surgery, a brace is recommended to protect the operative site during the healing period. For decompressive procedures without hardware, the bracing is for comfort and should be worn for 2-4 weeks after surgery. For procedures with hardware, you should wear your brace for 6-8 weeks after surgery
In addition to the brace or orthosis, a front-wheel walker and a 3-in-1 commode are the typical durable medical equipment (DME) prescribed for home use postoperatively. If needed, a hospital bed for home use may be ordered. These arrangements can be made prior to a hospitalization or at the hospital after surgery.
Outpatient physical therapy may be started only after Dr. Radcliff clears you to do so. Any visiting home physical therapy should be limited to a home safety evaluation and assistance with transfers from bed to chair or bed to standing, or transfers from standing to bed or sofa, and ambulation. No exercises should be done by the visiting home physical therapist. EXERCISES ON THE ABDOMEN, BACK, NECK, ARMS, OR LEGS SHOULD BE AVOIDED UNTIL CLEARED BY DR. RADCLIFF. These more advanced exercises are usually started 4-8 weeks after surgery, depending on the procedure.
Your return-to-work date depends on the type of procedure performed and the nature of your work. The timeframe may range from 2 weeks to 2 months, depending on the physical demands of your job. Generally, it is wise to resume work on a part-time basis such as 20 hours per week for 2-3 weeks, then advance to 30 hours per week for 2-3 weeks, then a full 40 hours per week. This gradual advancement allows your body to readjust to the demands of regular work duty.
Dr. Radcliff can see you and evaluate you. He can recommend what your next steps should be.