At Spine Colorado we favor the least aggressive approach that will bring you relief of your pain, which is why we do not recommend surgery for almost 90% of the patients we treat. In situations when conservative treatments are not effective, your physician may recommend spine surgery.
Lumbar Spine Surgeries (surgeries of the lower back)
Lumbar Spinal Fusion surgery is performed to join or fuse two vertebrae together. The surgery is intended to stop motion in that part of the spine and therefore decrease pain from degenerated joints. Implants and graft material are inserted to enable healing of the fusion to take place. There are several approaches to spinal fusion surgery, including lateral (side of the body), anterior (front), and posterior (back).
Discectomy is a very common procedure performed to relieve the pressure on the nerves and help decrease leg pain. This minimally-invasive procedure is performed through a small incision to remove the portion of the disc that is putting pressure on the nerves. The greatest chance of a recurrent disc herniation is within the first 3 weeks of surgery, so it is very important that you follow the post-operative restrictions provided.
Laminectomy is a type of surgery performed when the spinal canal becomes too narrow and compresses the spinal nerves, causing pain and sometimes other symptoms. This procedure is performed through the back of your spine to remove the lamina (bone) or thickened tissue (ligament) that caused the narrowing of the spinal canal, and therefore relieving the pressure on the nerves and decreasing leg pain. This operation is commonly performed as part of a decompression and fusion operation, but depending on your diagnosis, a decompression may also be performed without a fusion.
Cervical Spine Surgeries (surgeries of the neck)
Posterior Cervical Spine Fusion surgery is performed to join or fuse two vertebrae together. This is done through a midline approach through the back of your neck. A decompression is often performed at the same time to relieve pressure on your spinal cord and nerves by removing the bone and ligament that is causing compression. Implants and graft material are then inserted to enable healing of the fusion to take place.
Anterior Cervical Discectomy and Fusion (ACDF) is performed to address nerve pain caused by disc herniation, spinal stenosis and/or spondylosis. Going through the front of the neck, under general anesthesia, a discectomy will be performed which removes the disc, giving access to the spinal canal. The benefit of the anterior approach is that the disc can be accessed and removed without manipulation of the spinal cord. Bone graft or another material discussed by your surgeon will be used to replace the disc that was removed. Once in place, a titanium plate will be used to hold the graft in place and stabilize the construct.
Total Cervical Disc Arthroplasty is an alternative to fusion of the vertebrae and, unlike fusions, preserves motion of the spine. This surgical procedure can be performed in conjunction with an anterior cervical discectomy and decompression. While under general anesthesia, a small incision is made on the front of the neck and an artificial disc that will maintain motion similar to the native disc will be implanted. This surgery is designed to address a single level disc herniation or disc degeneration. Neuromonitoring will be used to monitor the function of your spinal cord and nerves.
Scoliosis Treatment generally starts with observation. In children, depending on growth and severity of curve, a brace might be recommended to keep curve from worsening. In severe cases of scoliosis, surgery might be recommended.
Important Surgery Information
Preparing for Surgery
Choose your Spine Coach
This can be a friend or family member that should be available to stay day and night with you for the first week after surgery, to assist you with daily actives and transportation needs.
You must be nicotine free for 4 weeks prior to surgery. Studies have shown that using nicotine products inhibits bone fusion and delays healing. Your surgeon may require a urine nicotine test prior to scheduling your surgery. You must be off ANY nicotine products for 10 days prior to taking a urine nicotine test. Being nicotine free helps increase the chance of a successful outcome.
Medications to Stop
Anti-inflammatories such as ibuprofen, Naproxen, Celebrex, and Advil need to be stopped 5 days prior to surgery. If you are on blood thinners such as coumadin or plavix, you will need to stop these medications 5-7 days prior to surgery once approved to do so by your physician managing these medications. Herbal remedies such as St. John’s Wart, Ginkgo Biloba, Ginseng, and diet aides can also increase bleeding. You can remain on Aspirin 81mg (baby aspirin) daily.
After a lumbar fusion, you will be required to wear a brace for 8 weeks after surgery. You will need to wear this brace while out of bed during the day. You are not required to wear the brace while sleeping.
It is important for you to walk a mile a day after surgery. This can be done all at one time or broken up throughout the day. Walking helps get a good blood supply to your back for proper healing, and helps prevent blood clots and pneumonia.
Traveling by plane is permitted after 4 weeks depending on how you are feeling. Keep in mind that frequent change of positions is necessary to decrease the risk of blood clots.
Traveling by car as a passenger can be done at anytime after your surgery. When driving more than an hour in the car, stop every 30 minutes, and get out and walk around for a few minutes to decrease the risk of blood clots and stiffness in the surgical area.
Returning to Work
Since work activities vary with each individual, please discuss the return to work with your surgeon. Check with your surgeon prior to increasing activity. It is important to return to activities slowly and very gradually as you progress through your recovery. If you become tired or are having increased pain, you may be pushing yourself too quickly.
Wear your brace at all times while out of bed
No lifting over 5 pounds
No repetitive bending or twisting
Do not smoke
Walk a mile a day
Change positions frequently
Limit sitting to 20 minutes at a time
Keep incision clean and dry
No baths or hot tubs until incision is scarred (approximately 4 weeks after surgery)
Wear compression stockings until walking a consistent mile a day
Do not resume anti-inflammatories until approved by your surgeon
Report any of the following concerns to your Surgeon
Increased drainage from your incision
Increased leg pain or weakness
Increased swelling or redness around the incision site
Fever or chills
Nausea or vomiting
Chest pain or shortness of breath is considered a medical emergency. Seek immediate medical attention.
Frequently Asked Questions
How long is my hospital stay?
Depending on the procedure, you will go home same day or spend one night in the hospital.
How long will I be on pain medication?
Most patients take pain medication for approximately 3-10 days postoperatively.
When can I drive?
Depending on the procedure, but generally once off all pain medications and after the first week of recovery.
When will I start physical therapy?
2-8 weeks after surgery, depending on the procedure performed.
When do I start walking a mile a day?
The day you are discharged from the hospital.
How long do I need to wear my stockings?
Until you are walking a consistent mile 5 days in a row.