Microsoft word - lumbar decompression dc instructions.doc

TOWN CENTER ORTHOPAEDIC ASSOCIATES
SPINE SURGERY
Dhruv B. Pateder, MD
POST-OPERATIVE DISCHARGE INSTRUCTIONS:
LUMBAR DECOMPRESSION
2. MINIMALLY INVASIVE LAMINECTOMY/FORAMINOTOMY 3. OPEN DISCECTOMY/LAMINECTOMY/FORAMINOTOMY 4. OTHER:_______________________________ I. ACTIVITY RESTRICTIONS until first follow-up appointment
A. Return to work will be discussed on an individual basis
B. No driving while taking NARCOTIC medications
C. You may slowly, progressively increase your activity as tolerated. While there
are no specific restrictions, please increase your activity slowly and do not overdo
it
D. Most patients do NOT need a brace after surgery. If you are prescribed a
brace, wear it as instructed by Dr. Pateder
ALWAYS be mindful of good body mechanics as discussed with your physical
therapist and/or Dr. Pateder before hospital discharge
II. PAIN MANAGEMENT
Post-operative pain is to be expected and will vary depending on several factors:
the type of surgery, prior use of narcotic pain medications, and personal tolerance
of pain. Given the individual variation of pain, your post-operative pain
management will be discussed with us on an individual basis prior to discharge.
A. After a lumbar decompression for leg pain, the nerve root may remain
inflamed for several days to weeks. This is due to the fact that the nerve root was
being compressed for an extended period of time and requires to “cool down.”
You may be placed on a short course of steroids to help reduce this inflammation.
Furthermore, it is normal for you to have some spasms and aching pain in the
back following surgery. These symptoms will resolve over time.
B. If needed, you may take over the counter anti-inflammatory pain medication
following surgery. The medications include: Motrin/Ibuprofen/Advil,
Alleve/Naprosyn, Excedrin, Lodine, Relafin, Celebrex, Daypro, Vioxx, Bextra,
Aspirin, etc.
C. Narcotic medications will only be refilled during office hours. Please be
aware of how many pills you have left so that you will not run out when the office
is closed.
III. INCISION CARE
A. Unless otherwise stated, your incision(s) have been sutured from the inside
with material that dissolves. Thus, there are no sutures or staples that need to be
removed at a later time. Overlying the incision are Steristrips which are similar to
the old “butterfly” bandaids. They provide extra support and will curl up and fall
off by themselves (usually in 1-3 weeks). If a Steristrip is starting to come off
and you can see that the incision under that strip is healed, you may go ahead and
pull off that Steristrip.
B. You will be sent home with a dressing over the Steristrips. You can remove
the outer dressing on postoperative day number 2. Thereafter, you may shower
and wash the Steristrips with soap and water. Gently dry the Steristrips until they
start to come off as described above. Do NOT soak the incision by taking baths
or sitting in a pool/hot tub until the incision is completely healed and the
Steristrips have fallen off (generally 2-3 weeks).
C. Healing tissue that will exist along your incision does not contain the pigment
melanin that normally protects the skin against the sun. For cosmetic reasons, it
helps to protect the incision from the sun by covering it with clothing or using
sunblock (if exposed) with at least SPF 30 or higher for 6 to 12 months.

D. You may remove the TED hose upon leaving the hospital if you are walking
independently.
IV. CALL our office (703 435 6604), your private physician’s office or present to
an emergency room IMMEDIATELY if any of the following occur:
A. Fever (>101.5 degrees Farenheit), chills or sweats that occur beyond 2-3 days
after surgery. It is NOT unusual to have a low grade fever (100.5 degrees
Fareneheit) for 2-3 days after surgery
B. Redness or swelling or warmth around the incision(s), NON-clear drainage
from the incision, or increased pain in or around the incision
C. Any neurological change in the arms or legs such as new weakness or
increased pain/tingling/numbness
D. Persistent or increased difficulty swallowing or speaking
E. Severe headaches that are different in nature to prior headaches and ones that
are worsened with standing and better with lying down
F. Abdominal bloating associated with persistent nausea and vomiting (often
these symptoms will be accompanied with constipation or inability to have a
bowel movement)
G. Calf swelling, redness, pain or warmth as this can be a sign of a deep venous
thrombosis (also known as a “blood clot”)
H. Chest pain, difficulty breathing or cough
V. FOLLOW-UP APPOINTMENT
Please call immediately upon discharge to make a follow-up appointment with us
in the office 7-14 after the day of your surgery. Let the office know that you are a
post-operative patient and must be added on to the schedule. If there are any
problems, please request to speak with Dr. Pateder or his assistant.
ALWAYS FEEL FREE TO CONTACT US WITH YOUR CONCERNS &
QUESTIONS AT 703 435 7704

Source: http://www.towncenterorthopaedics.com/wp-content/uploads/2013/03/Lumbar-DECOMPRESSION-dc-instructions.pdf