Once you decide to have surgery our surgical team will coordinate your day of surgery, and schedule preoperative appointments for medical clearance. These usually include:
History and Physical by Primary Care Physician
Specialty Clearance if necessary (Cardiologist)
Prior to surgery, we will also schedule you for a brace and bone stimulator if necessary as this helps with the fusion process and overall recovery.
Braces are used only for multilevel complex spine surgery. Bone stimulators are utilized to hasten the recovery and fusion process of the bone. This technology is provided by another company and typically covered by most insurance plans. These devices transmit waves of energy through the skin that stimulate the bone to grow and heal. You will be instructed on how to use this device by a technician prior to surgery.
On the morning of surgery, you are checked in at the NYU Hospital of Joint Disease by the nursing team. The Neuroanesthesiologists will come in to introduce themselves and explain what to expect prior to going in the operating room. The Operating Nurses will come out and speak to you as well. The first level of safety is that your incision is marked by the surgeon prior to entering the operating room – the operation is verified prior to any anesthesia. During this period, our Neuromonitoring team is placing leads on your skin for monitoring the nerves and spinal cord during surgery.
In the operating room you are put to sleep then after surgery is complete, anesthesia is stopped and you awake before going to the recovery room.
Patients spend at least 45 minutes in the recovery room prior to going to their private room for postoperative care. Some patients who require additional care go to the step down unit if necessary.
The discharge process begins the moment your surgery is done. Depending on the level of care, patients will either go home or to a rehabilitation facility. Typically, patients go home within 48 hours of surgery, again, depending on the complexity of your procedure. Prior to discharge, all medications are determined including pain medications and muscle relaxants. Dr. de Moura will provide you with his cell phone number for questions after the procedure if you cannot contact him through the office to provide the safest and acute care possible.
After surgery, you will find yourself to be very tired. As such, you will be spending half of your time resting and the other half, walking around. You will certainly be able to go to the bathroom and manage your surroundings without additional help. You will most likely be using pain medications on a routine basis. It is a good idea to have someone available to help you for the first two weeks or so at home.
Activities at this point should include a progressive walking program. Use of a stationary bicycle or treadmills are also allowed, although it may be too early to begin this program as of yet. Do what you feel you can do, but be conservative and safe. In any event, no lifting of greater than 10 pounds is allowed. Also, no stooping, twisting, lifting, housework, or yardwork are allowed at this time. A return to sexual activity may occur when you feel ready.
During this period of time, the wound must be kept clean and dry. It is recommended to keep a dry 4×4 inch gauze over the incision at all times. This dressing should be changed on a daily basis. Cover the wound with a cut piece of Saran wrap, secured with tape, for showering purposes. This will keep the incision dry during this process. Change this to a dry gauze once again after the shower. Place no lotions, powders, or ointments on the incision unless instructed to do so.
Keep track of your prescription medications. Write down a schedule as to when they may need to be taken. Please remember, narcotic pain medications usually require the actual written prescription. Do not wait until you are entirely out of medication to call the office for a refill. A 3 to 4 day warning to our office of your refill needs will make the whole process run more smoothly.
As the weeks progress, you can gradually increase your amount of activity however, your restrictions do not change at this point. Returning to work is based on your type of surgery, type of work, level of energy, and general comfort. In general, a laminectomy surgery allows you to return to a sedentary type of job within two weeks. A more involved fusion surgery combined with more physical types of work may require up to two or three months of recovery prior to returning to work. Discuss the specifics of your situation with your doctor for a better prediction of your particular needs.