Medications

Some medications can affect your surgery by causing bleeding or interfering with anesthesia. These medications include aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen. Also be sure to tell your surgeon about any supplements or natural remedies you take, as many of these have similar side effects.

Your surgeon will tell you which supplements and medications you should stop taking, and when you should stop taking them, in preparation for your procedure.  

Learn more: Preparing for Surgery: Medication Safety Checklist

Blood Transfusion

There is always a chance that some blood loss will occur during the procedure and that you may need a blood transfusion.

Most commonly, transfused blood comes from the blood bank. However, some patients choose to donate their own blood prior to surgery. You can ask your surgeon about the pros and cons of donating your own blood vs. using someone else's blood.

 If you decide to donate your own blood, your surgeon may prescribe an iron supplement to help build up your blood before surgery.

Advance Planning

You will be able to walk after surgery, but you after you return home you may need help with activities like washing, dressing, cleaning, laundry, and shopping. Before your procedure, arrange to get help with these activities for the first few weeks after surgery.

Even after minor spine surgery, your doctor may recommend that you do not drive for a period of time. For this reason, you will need to arrange in advance for transportation to and from your doctor's appointments and other places that you need to go during this time.

Talk to your doctor in advance if you have an extended car trip planned during your recovery. Your surgeon may recommend that you postpone your trip until your recovery is complete.

Before Your Operation

The night before surgery, you will need to stop eating for a determined period. This can vary widely, but often you should not have anything to eat or drink past midnight. Clear liquids, including coffee with no additives, are allowed closer to surgery. You might be given different restrictions if you are taking certain medications such as GLP1 agonists.

If a hospital stay is necessary after surgery, patients are usually admitted on the day of surgery.

After admission, you will be taken to the preoperative preparation area where you will be interviewed by a doctor from the anesthesia department. The anesthesiologist will review your medical history and physical examination reports.

Together, you and the anesthesiologist will determine the type of anesthesia to be used. This discussion sometimes takes place during an outpatient visit shortly before surgery, but it may happen the day of the procedure.

The most common types of anesthesia used for low back surgery are:

• General anesthesia (you are asleep for the entire operation)
• Spinal anesthesia (you may be awake, but you will have no feeling from the waist down)

You should tell the anesthesiologist about any past or current health issues and about any previous surgeries you have had. In addition, let the anesthesiologist know if you or anyone in your family has had problems with anesthesia in the past.

Surgical Procedure

The length of spine surgeries varies widely. These operations can be as fast as 1 hour or take up to a whole workday, depending on the complexity. You should ask your surgeon how long they expect your procedure to last.

When surgery is over, you will be moved to the recovery room, where you will be observed and monitored by a nurse until you awaken from the anesthesia. You will have an intravenous (IV) line inserted into a vein in your arm. You may also have a catheter inserted into your bladder.

When you are awake and alert, you will be taken to your hospital room.

For outpatient procedures, the nurses in the recovery room will make sure that you are able to walk, eat, and go to the bathroom before you are discharged home. They will also go over any postoperative instructions with you and make sure that you understand the directions for your medications. You may want to talk to the nursing staff about timing pain medications for just before discharge to make your trip home more comfortable.

Complications

The incidence of complications after low back surgery is low. Risks for any type of surgery include:

• Bleeding
• infection
• Anesthesia side effects like adverse reactions, medical problems such as heart attack or stroke, or even death 

Complications that are specific to spine surgery include:

• Failure to improve symptoms
• Difficulty with urination (retaining urine)
• Difficulty with intestinal function
• Blood clots
• Recurrent disk herniation
• Problems related to rods or screws
• Nerve damage resulting in pain, numbness, and/or weakness
• Spinal headache

Warning Signs

Your doctor will talk to you about how to recognize the warning signs of a blood clot or infection. These complications are most likely to occur during the first few weeks after surgery.

Blood Clots

Warning signs include:

• Swelling in the calf, ankle or foot
• Tenderness or redness, which may extend above or below the knee
• Pain in the calf

If you experience any of these symptoms, contact your doctor immediately. If you cannot reach your doctor, call 911 or have someone drive you to the emergency room.

Blood clots are potentially life-threatening, as they occasionally are able to travel through the bloodstream and settle in the lungs. This is called a pulmonary embolism. If this happens, you may experience:

• Sudden chest pain
• Shortness of breath or coughing.

If you experience these symptoms, immediately call 911 or have someone drive you to the emergency room.

Watch: Preventing Blood Clots After Orthopaedic Surgery

Infection

Infection is rare after spine surgery. Warning signs of an infection include:

• Redness, tenderness, and swelling around the edges of the wound
• Drainage from the wound
• Pain or tenderness
• Shaking chills
• Elevated temperature, usually above 100°F if taken with an oral thermometer

If any of these symptoms occur, contact your doctor immediately or go to the emergency room.

Wound Care

• If your wound was closed with stitches (sutures) or staples, they will usually be removed at your first post-operative appointment.
• If your wound was closed with absorbable sutures, they do not have to be removed.
• If you have wound drainage after you are home, cover the wound with a bandage and call your surgeon. 

Diet

• Some loss of appetite is common after surgery.
• During your recovery, it is important to eat well-balanced meals and drink plenty of fluids.
• Your doctor may recommend an iron supplement or vitamins before and after your surgery.
• It is not a good idea to go on a weight loss diet right after surgery. this can interfere with essential nutrition, which may delay wound or bone healing. Instead, you should focus on eating nutritious foods and getting adequate quantities of protein and fiber.

Ask your doctor if you have questions about your post-surgery diet. 

Activity

• Many people experience a loss of energy after major surgery, but this improves over time.
• It is very important that you do not stay in bed for prolonged periods of time right after surgery. You should get up every hour or so and take at least a few steps. This will help with your rehabilitation and decrease the chance of blood clots.
• Your doctor may prescribe an exercise program designed to gradually increase your strength and stamina.
• Initially, your doctor will recommend that you participate in light activity like walking. Later, you will be encouraged to swim or use an exercise bike or treadmill to improve your general physical condition.