It was a pleasure caring for you during your admission to NYU Langone Health. Below are important instructions to manage your health. You will also find contact information for scheduling appointments and imaging tests/procedures. You may receive a survey after your stay. We appreciate any feedback you can give us. Your feedback will help the care team always provide excellent care. Thank you.

General Discharge Instructions Following Spine Surgery

Please follow these instructions during your recovery after surgery.

Incision Care

• Keep incision covered, clean and dry for 3 days from the time of your surgery.    
• Change dressing daily with dry gauze and paper tape as needed. After 3 days post-operatively you no longer need to wear a dressing.
• No shower until the 3rd day after your surgery, if no drainage is noted on the dressing. You are encouraged to shower daily. Do not soak your incision. Pat dry the incision.  Avoid swimming and bathtubs/Jacuzzis/hot tubs until cleared by your surgeon.
• If drains were used post-operatively, you will have smaller incision(s) near the main incision. These will either be closed by Steri-Strips or sutures (black threads).
• If you have any sutures or staples, they may be removed 2-3 weeks after surgery.
• If you have Steri-Strips, Dermabond (skin glue), or (Prineo Skin closure) may be present to aid in holding the skin edges of your incision together, do not remove them. These will fall off on their own.
• Do not apply any lotions, ointments, or creams to the incision until cleared by your surgeon.
• You may notice some itching as the incision heals. Do not rub or scratch the incision.

Notify your surgeon immediately if:

• Pus or cloudy fluid leaks from the incision or the discharge has a foul odor.
• The skin starts to separate.
• The incision becomes increasingly painful, warm, or there is increased redness.
• You have a temperature of 101.0 F or greater.

Activity

• No driving is permitted until cleared by your surgeon. You must be off opioids/controlled substances to drive.
• Walk as tolerated, letting pain be your guide. You may go up and down stairs as tolerated, using the handrail for safety.
• Avoid activities that include bending or twisting at the waist level.  
• Do not lift anything that weighs greater than 10 pounds until cleared by your surgeon.
• Limit prolonged sitting/standing to 30-40 minutes at a time for the first 2-3 weeks.
• Wear brace as instructed
• You may resume sexual activity once cleared by your surgeon
• You may resume light work around the house; lifting not to exceed 10 pounds.

Respiratory Hygiene

• Deep breathing is very important after surgery to maintain lung expansion and reduce the risk of pneumonia. You will be provided with an incentive spirometer and instructed about its use. This device should be used every hour during your wakeful hours initially, then every 1 to 2 hours as your activity returns to normal. This device is yours to take home. Continue to use it at home for at least 1 week after your discharge. (Use it during TV commercial breaks).
• Smoking and vaping are absolutely forbidden. There is clear evidence that smoking/vamping dramatically increases your risk of post-operative complications. There is also evidence that smoking adversely effects bone healing and nerve recovery. Second hand smoke also applies.
• Please check with your surgeon if you can use nicotine patches after surgery.

Disability

• Some patients may return to work sooner than others depending on their job, response to surgery, and ability to perform other lighter tasks in the work place. Physician approval is required prior to returning to work.
• If your employer requires documentation of your work status, our office will provide the necessary information to your employer or other concerned parties. All disability matters may be handled by contacting our office.

Medications
You will be prescribed pain medication to take for a short period of time after surgery. Narcotics are very effective for pain relief but may cause other side effects. The possible effects vary among patients and may include: sleepiness, nausea, constipation, flushing, sweating, and occasionally euphoria or confused feelings are possible.

If these occur please direct any questions regarding the use of these medications to your surgeon and/or his/her NP/PA.

Home Pain and Medication

When we surgically relieve pressure from an inflamed, damaged nerve it does not recover instantaneously. The surgical procedure does not heal the nerve, only the body is capable of that. The goal of surgery is to create the best possible environment for the body to heal itself and to prevent further damage. This will take a variable length of time depending on the duration and degree of nerve damage and the body's own healing abilities. Most of the healing occurs in the first few months. Pain, weakness, or numbness lasting more than six months will likely be permanent.

Constipation

Anesthesia and pain medications can cause constipation. It is recommended that you take a stool softener, such as Colace, while you are taking prescription pain medication; this is available over-the-counter. Using over-the-counter laxatives such as senna, Milk of Magnesia, Miralax, and Magnesium Citrate can help relieve constipation. You can begin to take laxatives after you are discharged if you have not had a bowel movement (after discussion with your surgeon). Increasing your walking/activity and staying hydrated will help alleviate constipation. We also recommend a fiber rich diet which includes whole grains, legumes, fruits and vegetables; warm prune juice may also help.  

For patients who have had an instrumented fusion:

• Do not take nonsteroidal anti-inflammatory drugs (NSAIDs) such as Motrin/Advil (ibuprofen) or Aleve/Naprosyn (naproxen) for 3 months after surgery. These can interfere with bone healing.
• If you are planning to undergo a dental or medical procedure (such as endoscopy, colonoscopy), contact your surgeon to see if pre-procedure antibiotics are required.
• Your spinal instrumentation will not set off airport alarms/metal detectors, nor inhibit you from having future MRI scans.
• If you were given a brace and/or bone stimulator, use as instructed by your surgeon.

General Guidelines
Call your surgeon's office to schedule a follow-up appointment.

If you have questions or concerns, please call the surgeon's office during normal office hours. If the office is closed, you will be connected to the physician on call.

Please refer to your surgeon's office for specific discharge instructions for postoperative care

Recovery at home: Setting up for Success

• Your care does not end once you are home, we are here to assist with your transition of care.  
• If appropriate, you will be set up with visiting nurse services, along with physical therapy at home, once discharged.
• You will receive a call from a discharge nurse 1-3 days after discharge.

Suggestions for things to be in place once discharged:  

• Your home should be free of clutter and safe for walking. For example: your home should be free of loose rugs, toys, or wires that can potentially cause you to trip and fall.
• All your medications (pain medication, muscle relaxant, laxative) should be close to you to take as needed.
• You should have food stocked in the refrigerator or freezer to eat during the week or means of easy access to food.  
• Make sure you have someone that lives close by who can assist you if needed.
• You are expected to progress gradually.  The goal for the first week is to walk around your home.

**If you have any concerns, please contact your surgeon's office**