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Patient Discharge Instructions: Cervical Spine Surgery

Your surgeon has written the following discharge instructions for you. Please take the time to review these instructions prior to leaving the hospital. We will be happy to answer any questions that you have.

First Follow-Up Appointment

You should have a follow-up appointment already scheduled at the time of your hospital discharge. If not, please contact our office at (920) 882-8200 or toll free (888) 231-5236 as soon as possible so that an appointment can be made.

Incision Care

Your incision may be closed with sutures, or dissolvable sutures under the skin covered with Steri-Strips. The dressings should be removed on your first or second post-operative day. If drainage persists, you may apply a light dressing and change it daily. Your incision can otherwise remain uncovered since dressings can trap moisture, which may lead to infection. Unless instructed to do so, do not apply any antibiotic ointments or antiseptics on the incision. Do not pull at Steri-Strips or sutures. They will be removed at your follow up visit in 7-14 days. If you have Steri-Strips they may fall off on their own in 7-10 days or will be removed at your postop appointment. You may shower but avoid bath tubs/hot tubs or other activities that would involve submerging the incision under water until it is well healed (2-3 weeks).

It is not uncommon to have a small amount of swelling or fullness around the incision and a sore, scratchy throat after surgery. This may be due to the surgical procedure itself and/or the breathing tube placed during the surgery. You may apply a cold pack to the incision regularly to reduce incisional pain and swelling. Throat irritation can be treated with ice chips, popsicles, fluids and a light diet that is easy to swallow. This should improve within a few days. A rapid increase in neck swelling, inability to swallow or speak clearly, or difficulty breathing may represent a rare yet potentially life-threatening complication and you should call 911 to summon emergency care immediately.

If you had bone marrow aspirated from your hip, you may have Steri-Strips and or a Band-Aid on the site. The above information applies to these sites as well.

Collar

You may be sent home with a cervical collar to help minimize range of motion of your head and neck. This collar may be simply for comfort or you may be instructed to wear it on a scheduled basis. You will be given specific instructions regarding use of the collar by the time you are discharged. If you are uncertain, please ask. If instructed to wear it at all times that also includes sleeping. You will likely be permitted to remove it briefly for showering. Plan to wear the cervical collar to your first postoperative appointment. Your surgeon will advise you how long you are to wear the collar beyond that time. .

Pain Medication

You will be given a prescription for pain medication such as Percocet (oxycodone/acetaminophen) or Vicodin (hydrocodone/acetaminophen). Please use this as directed by your provider for moderate to severe pain. Narcotic pain medication can cause constipation, dizziness, nausea, headache and decreased energy. Use the narcotic pain pills only when needed, as the goal is to discontinue them as soon as possible. Most people take the narcotics for a day or two after an anterior (from the front) surgery, and 5-7 days after a posterior (from the back) surgery.

For mild to moderate pain you may take Tylenol (acetaminophen) 325-1000 mg every 4-6 hours, as needed. Please note that Tylenol is often a component of some common narcotic and non-narcotic pain relievers. Tylenol from all sources should not exceed 3000mg in 24 hours. Older people or those with kidney or liver impairment may be advised to take lower doses of Tylenol. To prevent constipation caused by narcotics, drink 6-8 glasses of water per day and eat plenty of fruits and vegetables. If needed, an over the counter stool softener or laxative can be purchased. If you continue to have trouble with constipation, contact your primary health care provider for further instructions.

Any need for prescription refills should be addressed with our office during regular business hours by calling (920) 882-8200 or toll free at (888) 231-5236. Some pain medications such as oxycodone require a written prescription. If this is the case, a refill cannot be phoned to the pharmacy so the prescription will need to be picked up at the office or mailed. Please allow enough time for that process. We do not refill narcotics after hours, or after noon on Fridays. Plan ahead and give us at least 24 hours to get the script ready for you.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDS such as Aspirin, Advil (ibuprofen) and Aleve (naproxen) and others, interfere with bone fusion and ideally should NOT be taken for 3 months following fusion surgery. Low dose aspirin prescribed for your heart is appropriate to continue after spinal fusion. If you have any questions, please ask your surgeon.

Cold/Ice Application

For the first couple of weeks, you may find cold application helpful in reducing pain and inflammation in the surgical area. We recommend that you apply ice or a cold pack at least 20 minutes every few hours for the first 48 hours while awake. You may continue this for as long as you find it helpful.

Driving

You should not drive while taking narcotic pain medication because it may impair your ability to drive safely. Otherwise, driving is permitted but neck mobility will be limited, and will require extra safety precautions. For that reason, you may prefer to avoid driving while you are immobilized in a collar. Keep in mind that firm cervical collars are more restrictive than soft foam collars.

Activity and Exercise

Let pain be your guide. This is not the time to catch up on major household chores or perform heavy labor. Minimize heavy lifting and overhead work for the first 12 weeks. You might also find it helpful to limit prolonged periods of time seated at the computer. Walking is encouraged. Stair climbing is permitted. You may sleep in any position you find comfortable. Water exercise may be appropriate but only after your surgeon advises you to do so. Resume sexual activity when you are comfortable doing so.

Smoking

If you had a cervical fusion, we have counseled you on the importance of avoiding all forms of nicotine as it may interfere with your fusion and the success of your surgery. Each year more than 430,000 deaths in the United States are attributed to tobacco related illness. If you smoke or chew tobacco, we strongly encourage you to stop. If you would like more information on this topic, please ask us.

Please call us if:

  1. You develop a fever of 101° F or more, or redness/swelling/foul drainage at your surgical site.
  2. You develop increased neurological symptoms (confusion, weakness, numbness, tingling, etc.).
  3. You develop any adverse response to your medications.
  4. You have other questions.

** Each year more than 430,000 deaths in the United States are attributed to smoking related illness. If you smoke, we strongly encourage you to stop smoking. If you would like information about stopping smoking please ask us.

** If you have Congestive Heart Failure, please call your doctor if you experience a weight gain of 2lbs in one day, or 3lbs in 2 days or 4lbs in one week.