Anterior and Posterior Spinal Fusion
Your doctor has recommended surgery on your back to correct your present condition. This surgery is called an anterior (an-TEERee-or) and/or posterior (poh-STEER-ee-or) spinal fusion (FEW-zhun). A fusion is performed to keep separate sections of the spine secured. It’s like a weld to hold bones together. Bone from your hip is used to create the fusion. Screws, rods, or hooks are used to help secure the fusion. The fusion may take six or more months to become solid. The surgery also involves removing disks or bone spurs that are causing problems in your back.
An incision (cut) will be made on your back (see the diagram below). The size of the incision will depend on the extent of your problem. A second incision will be made on the back of your hip (see the diagram). Bone will be removed from your hip and will be placed in your back. This will be used to create a bone fusion. The surgery may take eight to 12 hours. The average length of stay in the hospital is seven days.
Your incision will be closed with either metal staples or stitches, which may be reinforced with Steri-strip tapes, paperlike strips that stick to your skin and help keep the sides of the incision from shifting. The metal staples will be removed by your doctor or visiting nurse about 14 days after surgery. The stitches will dissolve completely. The Steri-strips will fall off by themselves,usually within two weeks of surgery.
After the Operation
A tube may be inserted through your nose and into your stomach after surgery. This is called a nasogastric tube. The tube may be uncomfortable, but it will keep you from being sick to your stomach after surgery. You may be given ice chips while the tube is in place. After the tube is removed, you will be given clear liquids. When normal bowel function returns, you will be able to eat a regular diet.
A chest tube may also be inserted into the side of your chest. Your doctor will record drainage from the chest tube. You will have a chest x-ray every day while the tube is in. The tube is usually removed within three to four days.
Either the first or second morning after surgery, staff will help you get out of bed to sit in a chair for 20 minutes. You should limit sitting and walking to 20 minutes at a time to keep your back from getting sore. Physical therapy usually begins after the chest tube has been removed. Physical therapy department staff will teach you proper body movement and exercises to strengthen your back. A staff member or physical therapist will help you get a cane or walker after surgery.
A brace is usually needed to provide extra support for your back after surgery. You will be measured for the brace the morning after surgery. You must wear the brace while walking or sitting in a chair. If your doctor allows, you may be able to get up to go to the bathroom without the brace. Although you will wear the brace for about three months, it may take eight to 12 months before the fusion is solid.
You may need a short inpatient stay at a rehabilitation facility. Your doctor will decide with you if this is necessary.
- Do not return to work until your doctor says you may.
- Do not drive until your doctor says you may. Your reaction time may be slower due to pain or certain prescribed medications. This is a safety concern as well as a legal issue.
- You may ride in a car from the hospital to your home. However, you should not take car trips until your doctor says you may.
- Walking is good for you, but you should rest as needed. Do not get overtired. Try to limit going up and down stairs to once a day for one to two weeks.
- Avoid strenuous exercise or activities like swimming, golfing, or running until you check with your doctor.
- Do not bend from the waist to pick up things. This movement strains your back muscles. You should bend your knees and squat instead.
- Do not carry heavy items, such as groceries or laundry. Do not lift anything heavier than a gallon of milk. Do not try to move heavy furniture until your doctor says you may. Do not lift anything over your head.
- Keep the incision dry. Take sponge baths; do not take tub baths until your doctor says you may. Showering is usually allowed seven to 10 days after surgery, if the incision is not red or draining. Before showering, remove the brace and cover the incision with plastic wrap, to keep water from hitting the incision. Be sure to use a rubber mat in the shower, to prevent slipping. Be careful not to move your neck from side to side while the brace is off.
- Usually you may sleep in any position that is comfortable. You should not sleep on your stomach, because this strains your back muscles.
- You may resume sexual activities when your doctor says you may.
- Do not sit in soft or overstuffed chairs. Firm chairs with straight backs give better support.
- Incisions may be numb or tender for a few weeks after surgery. Some redness around the incision is common and usually disappears within one to three weeks. Ask a family member to help you check your incision regularly.
- A raised toilet seat will be provided for you. If necessary, other assistive devices will be arranged for you by hospital staff or your primary care doctor.
When to Call the Doctor
If you notice any of the following signs of infection, call your doctor or nurse immediately:
- Increased redness at the incision site
- Increased pain at the site
- Increased swelling at the site
- Puslike drainage from the site
- Black tissue around the site
- Fever of 101°F (38.3°C) or above for more than 24 hours
Use common sense in judging what you can and cannot do. If you have any questions or concerns, please feel free to call your doctor or nurse.
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