Post Operative Instructions for Cervical Fusion

ANTERIOR CERVICAL DISCECTOMY AND FUSION (ACDF) /POSTERIOR CERVICAL FUSION (PCF)

INSTRUCTIONS AFTER SURGERY

Pain expectations

• A sore throat often occurs after intubation for anesthesia. After all surgeries, inflammation is a natural process of healing. We cannot and do not want to block this process. Please know we can take the “edge” off your pain, but we cannot stop ALL your pain. With each day that passes you will get stronger and oftentimes, must simply be patient as nature clicks off days on the calendar. You need to be encouraged by the “good days” as the “bad days” get further apart.

Wound care

• Keep your incision dry and clean.
• Bandages (dressing) need to be on incision until first post op appointment.
  • Dressing needs to be changed daily
  • Dressing is not provided by the hospital or surgeon to take home but can be purchased at your local pharmacy or drug stores.
• Let the steri-strips (tapes on your wound) fall off by themselves. If some remain attached 2 weeks after surgery, you may gently peel them off
• Do NOT put any ointments/lotions/antibiotic solutions on the incision
• If you notice drainage, redness, swelling or increased pain at the incision, call the office

Showering

• You may shower when the wound has been clean and dry for 24 hours. Do don’t scrub the incision or soap it. Just let water run over it.
• Make sure you pat the incision completely dry after showering. Be gentle – do not scrub the incision.
• Do not immerse the incision in a pool or bath until 6 weeks after surgery

Collar

• If you have been instructed to wear a collar full time, you can take the collar off 4-5 times per day for 15 minutes at a time. However, keep your head looking straight ahead during these times as much as possible
• If you need a collar to wear while showering, it will be provided to you before you leave the hospital. If you have not been given a shower collar, you may shower without any collar
• You can remove the collar to shave, but try not to flex or extend your neck while doing so.
• Keep looking straight ahead as you do these activities.
• If you have been instructed to wear a collar for comfort only, you may wear the collar at your discretion if you feel that it provides you comfort. If you do not want to wear it, you do not have to.
• Some patients will be instructed not to wear a collar at all.

Skin abrasion from the collar

• If you have skin abrasions from the collar, you can lightly apply tac powder (baby powder) between the skin and brace
• Do not apply talc powder (baby powder) to open sores or the incision itself
• Alternatively, you can place a scarf or handkerchief between the area of skin abrasion and the collar

Activities

• Do not drive a car unless your surgeon has specifically allowed you to do so, or until you have seen your surgeon or his PA at your first post-operative appointment.
• Walk as much as you like. Walking is good for you
• No strenuous or sports activities until okayed by your surgeon
• DO NOT lift anything over 15 pounds
• Sexual activity is permitted as tolerated

Follow up

• We have already scheduled your fist post-operative appointment please refer to your letter for date and time. Most post-operative appointments are generally made 2-3 weeks after your surgery and will be with our PA David Pope; however Dr. Sharma will be in office for any questions or concerns.

Medications

• PLEASE DO NOT TAKE ANY NON- STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDSs like Advil, Celebrex, Aleve, Ibuprofen, Motrin, Vioxx, etc) FOR 3 MONTHS AFTER SURGERY. These medications can adversely affect fusion. If you absolutely need to be on these medications sooner, please check with your surgeon first.
• If you were on baby aspirin prior to surgery, you may generally resume that 4 weeks after surgery.
• Monitor narcotic use after surgery to anticipate your need for refills. Dr. Sharma does not call in prescriptions after hours, Fridays, or on weekends. You will have to go to the Emergency Room if you run out of pain medications during these periods.
• PLEASE NOTE FOR PRESCRIPTION REFILLS YOU WILL NEED TO CALL AT LEAST 48-72 HOURS IN ADVANCE.
• Narcotics often cause severe constipation. To help with this, make sure you take Colace 100mg twice a day regularly. If still constipated, try 20ml of Mineral Oil and 20ml of Milk of Magnesia mixed daily.

Call our office at (855) 774-6334 immediately if you:

• Have significant drainage (more than just a few drops) and/ or odor from your wound.
• Have increased redness/swelling at the incision site
• Have a fever greater than 101 degrees
• Have new or unfamiliar pain or weakness in the arms or legs
• Have unexplained incontinence (“accident”) of bowel or urine, are unable to urinate, or have new onset of pain or numbness in the rectal, vaginal or scrotal area.