It’s especially essential to maintain or improve motion through your hips, knees, and upper back after a lumbar fusion. Flexibility, core strengthening, and an emphasis on function during the postoperative course helps to optimize your motion.

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Will the fusion affect the health of the rest of my spine?

This is a complex discussion. A fusion can place some stress on other levels of your spine. However how and why it does this can be controversial and depends on your individual situation and predispositions. Your surgery was done for a degenerative condition that may affect other parts of your spine in the future. If you have had surgery at one level in your spine, it is possible that the degenerative process could take place at another level. Since the spine has 36 levels, this is not unusual over a lifetime. Most people handle degenerative difficulties with self-care and non-operative care. That being said, Dr. Paul and his team go to great lengths to minimize the chances of needing additional care for your spine. That includes careful surgical planning, intraoperative decision making, and post-operative care.

Dr. Paul will prescribe pain-killers, also known as analgesics, to reduce the discomfort of this post-surgical recovery period. Medications prescribed can range from over-the-counter NSAIDs (after the first five days) to potent prescription opioids depending on the projected severity of pain.If you are or have undergone a fusion procedure, you should avoid NSAIDs for the first 6 weeks.
Patients should take care to manage their dosing relative to the pain experienced. Opioids can usually be tapered off within the first two weeks of surgery. NSAIDs may be taken with protective measures for the gastrointestinal system such as proton-pump inhibitors (PPIs) such as omeprazole, antacids such as TUMS, and bismuth salts such as Pepto Bismol to reduce the risk of ulcer formation.

Night Time and Transitions:

It is very common to have increased pain at night and when you first get up out of bed. Any time you remain in one position for an extended period of time the muscles may tighten and swell and you can experience pain. As a result, transitioning can bring on pain.
Transitioning includes lying to sitting, sitting to standing. Anticipate this and use medication appropriately and or take time to do these activities. Do not try to move quickly. You won’t do anything to harm your surgery but you may have an increase in pain. This will improve with time.

Stairs and Toilets:

You may have some mild to moderate discomfort going up and down stairs immediately after surgery. However, you are allowed to do so since you will not hurt your surgery. Similarly, getting on and off the toilet may give you some discomfort but you will not do any damage to your surgery. If you have a lower toilet, a raised toilet seat may be helpful.

It is very common to have elevated temperatures post-operatively.

You may notice your body temperature fluctuating between 99-101.0 degrees. This is commonly due to the body’s reaction to the trauma of surgery, as well as pain medicine causing slight changes in breathing by not allowing our air sacs in the lungs to expand (atelectasis). Use the breathing machine (if received during your hospital stay) or be sure to take a deep breath 10 times per hour while awake to aid in keeping the lungs healthy and the body temperature down. It is very rare to develop a postoperative infection within the first 2 weeks after surgery. If you have sustained temperature greater than or equal to 101.0 or have concerns, call our office to discuss.

Urinary Retention.

If you have had trouble urinating after other surgeries, please let Dr. Paul’s team know. We can sometimes become concerned with urinary retention after surgery since this can be a sign of spinal cord compression which can lead to permanent effects if not quickly addressed. If you have a history of an enlarged prostate or prior history or postoperative urinary retention, please let us know.

Sore Throat.

Surgeries performed under general anesthesia will involve placing a tube down the windpipe to facilitate breathing during the operation. Irritation can persist for a few days, but will usually resolve on its own.

The Blues.

It is not uncommon to feel mildly depressed or anxious for the first 4-6 weeks after any surgery, but those feelings should go away as your daily activities and exercise resume. This is more common with larger or multilevel surgeries. If depression continues, please consult with your primary care doctor.