Frequently Asked Questions (FAQ)
When should I call the office/hospital with concerns?
Call the office if you have a high fever (101.5 or higher), drainage from the incision site, new weakness or pain, difficulty breathing, leg swelling. Some redness and swelling around the incision site are normal and expected after surgery. The swelling can actually get worse for the first 3-4 days after surgery, and this is normal. This will take another 2 weeks for the swelling to subside.
When should I come back to have a post op neurosurgery visit?
Call the office after surgery to arrange for a follow up appointment, as follows:
Brain Surgery:
First follow up: Around 7-10 days after surgery to remove staples
Second follow up: Around 3 months after surgery
Spine Surgery:
First follow up: Around 10-14 days after surgery for incision check
Post Op xrays: If your surgery was a fusion, xrays will be ordered and done near the end of the 3rd month
Second follow up: Around 3 months after surgery (after post op xrays are done, if required)
What do I have to do to care for the incision site?
Most incisions will have dissolvable sutures under the skin, so there will be no sutures/staples to remove. The skin will be covered with a clear surgical glue called Dermabond (which is similar to Crazy Glue). It is a clear film that will turn dark and will fall off over 2-3 weeks. With the Dermabond, you can shower normally the evening of surgery.
When will I feel improvement?
After spinal surgery, your referred pain (in your arms and legs) will be the first to improve. This may be within the first few days or weeks. If you had weakness prior to surgery, your strength may take 2-3 months to improve, depending on your willingness to exercise and strengthen the muscle loss that you had. You may have increased neck/back pain from the surgery itself, which is expected and within the norm, and this can take around 3 months to subside. You may have some new numbness after surgery, which can be expected from nerve retraction (to protect the nerve) during surgery or could be from your pre-op symptoms. Numbness and tingling can take up to 3-6 months to recover and can sometimes be permanent.
What symptoms are normal and expected after surgery?
After spinal surgery, you will experience more neck/back pain than you may have had, depending on the site of surgery and the extent of surgery required. Stiffness and muscle spasms are normal. If you had a spinal fusion with titanium screws and rods inserted, then you will experience rigidity and limited flexibility at that area. Changes in the weather/humidity may affect your discomfort more noticeably. You can feel like your neck or back is on strain and feeling of being "pulled or stretched". You can develop referred pain from your neck into the back of your head, or from your lower back referred to your upper back. Depending on your required position on the operating table, you can experience soreness on your shoulders, elbows, chest, hips, thighs, and knees. Most of these will subside within the first 2 weeks and resolve within the first 2 months.
What can I do to quicken the recovery?
Your recover is limited by time and your body's process of healing from the disease process and from the effects of surgery itself. However, you can help your body by being active, walking at least 30 minutes a day and maintaining a healthy diet and lifestyle. There are no vitamins or magic pills to get you better. There is no recommended cream for your incision site, and it is best to keep it clean and free of any ointments that could introduce infection to the site. Gentle stretching will help with muscle tightness. Isolated muscle strengthening can be used as part of your exercise regimen, along with working with a physical therapist.
What can harm the surgical site and risk having further surgery?
Poor wound healing and surgery recovery, especially with spinal fusion, is associated with smoking, obesity, and uncontrolled diabetes. Try not to over-do it during the first 2 months after surgery, even if you feel great. You are at the highest risk of re-injury during the first 2-3 months after surgery. Heavy lifting (20 lbs) and extreme bending should be avoided. High impact activities (running, jumping, golf swings, etc) should be avoid until your 3 month post op visit. Do not soak the incision site in a bath tube or pool or body of water during the first 2 months, since this may introduce bacteria and infection.
Will I be on Opioids prescription pain medicine?
You will be given 1-2 weeks supply of opioid or equivalent prescription for your post-op pain. It is OK to take this if your pain is severe. You do not need to take it if you do not have pain or have pain that can be controlled with over the counter medications (Tylenol). You will not become dependent on the pain medications, if you follow the prescribed instructions and only ask for refills from your surgeon during the first 2 weeks. If you need further pain control beyond the initial post-op period (usually any period longer than 2 weeks), you will be referred to a doctor who specializes in opioid medication management (pain doctor; physiatrist). Opioids will make you constipated, so you can take over the counter laxatives to help with that known side effect. Your local pharmacist can help recommend laxatives to you.
When can I resume driving?
Once you no longer need to take prescription medications for pain, you can resume your previous driving 24 hours after your last prescription pain medicine. You should not drive if you are wearing a neck brace. You can drive while wearing your lower back brace, if that is comfortable for you in your car seat. As a driver or a passenger, avoid long car trips during the first 2-3 months. If necessary, take breaks every couple of hours.
When can I go back to work?
This depends on the type of surgery you had and the time of work you do. For minimally invasive spine surgery in a patient who works in the office without heavy lifting, you can go back to work within the first few days or couple of weeks. If you had weakness prior to surgery, plan on recovering 2-3 months to get your strength back. If your work requires heavy lifting (more than 20 lbs), then plan on staying out of work for the first 3 months.