Your Procedure
Complete surgical guide
About Your Surgery
What You'll Need at Home
Essential Items
- Ice packs
- Comfortable, loose clothing
- Slip-on shoes
- Grabber/reacher tool
- Firm pillows
Bathroom Items
- Shower chair or bench
- Long-handled sponge
- Raised toilet seat (if needed)
- Non-slip bath mat
Required Before Surgery
✓ Required for ALL Surgeries
- CT Scan - Must be completed prior to surgery
- MRI - Must be within 1 year
Medications
STOP 7-10 Days Before
- Aspirin
- Plavix (clopidogrel)
- Coumadin (warfarin)
- Xarelto, Eliquis
- NSAIDs (ibuprofen, Advil, Aleve)
- Fish oil, vitamin E
CONTINUE Taking
- Blood pressure medications
- Heart medications
- Thyroid medications
- Diabetes medications (may need adjustment)
Week Before Checklist
Confirm surgery date and time
Complete all clearances and lab work
CT scan and MRI completed
Arrange transportation and help at home
Stop smoking (critical for healing)
Purchase supplies
Submit insurance authorization
Complete disability paperwork
Your Surgery Timeline
2-4
wks
wks
2-4 Weeks Before
- Surgery scheduled
- Insurance authorization submitted
- Complete pre-op testing
- CT scan and MRI confirmed
1w
1 Week Before
- Stop blood thinners
- Purchase supplies
- Arrange help at home
- Complete disability forms
1d
Night Before
- Shower with antibacterial soap
- Nothing to eat/drink after midnight
- Pack bag with ID and insurance
0d
Day of Surgery
- Arrive 2 hours early
- Pre-op preparation
- Surgery (1-4 hours)
- Recovery room
1w
First Week Home
- Pain management
- Wound care daily
- Walk frequently
- Follow restrictions
2w
2 Weeks Post-Op
- First follow-up
- Wound check
- Suture removal
Wound Care
Basic Wound Care
- Keep incision clean
- Don't get it wet - avoid water on incision
- Check daily for signs of infection
- NO baths, pools, or hot tubs until healed
Dressing Instructions
Silverlon Dressing
If Silverlon dressing was provided:
- Exchange in 7 days with new Silverlon dressing
- Keep dry until exchange
Collagen Dressing
If collagen dressing was approved:
- Follow manufacturer's instructions
- Do not remove unless instructed
If Wound Needs Cleaning
- Use peroxide to clean wound
- Pat dry with sterile dressings
- Do not rub or scrub
Activity Guidelines
DO NOT
- Bend at waist beyond 90°
- Lift more than 5-10 lbs
- Twist your spine
- Drive (until cleared)
- Smoke
DO
- Walk frequently
- Use proper body mechanics
- Log-roll out of bed
- Wear brace if prescribed
- Take medications as directed
Durable Medical Equipment (DME)
You may need special equipment to support your recovery. Here's what might be prescribed.
Braces
A brace may be prescribed to support your spine during healing.
Cervical Collar (Neck Brace)
- Worn after cervical surgeries
- Typical duration: 6-12 weeks
- Wear as directed by surgeon
- May remove for showering if approved
Lumbar Brace (Back Brace)
- Worn after lumbar/thoracic surgeries
- Typical duration: 6-12 weeks
- Provides support during healing
- Wear when upright and walking
TLSO Brace
- Thoraco-Lumbar-Sacral-Orthosis
- For thoracic and multi-level fusions
- Custom-fitted to your body
- Worn 3-6 months typically
Bone Growth Stimulators
A bone stimulator may be prescribed to help your fusion heal properly.
What is a Bone Stimulator?
An electrical or ultrasound device that promotes bone healing and fusion. Used externally (worn over skin) or internally (implanted).
Indications for Bone Stimulators
You may need a bone stimulator if you have:
•
Multi-level fusion - More than 2 levels fused
•
Osteoporosis - Weak bone density
•
Smoking history - Impairs bone healing
•
Diabetes - Affects healing
•
Previous failed fusion - Nonunion or pseudarthrosis
•
Revision surgery - Second or third spine surgery
•
High-risk for nonunion - As determined by surgeon
Types of Bone Stimulators
External Stimulator
- Worn on skin over fusion site
- Use 2-9 hours daily
- For 3-9 months
- Electrical or ultrasound
Internal Stimulator
- Implanted during surgery
- No daily maintenance
- Works continuously
- Battery powered
Insurance Coverage
Bone stimulators are usually covered by insurance when medically necessary. Our office will help with authorization if prescribed.
Insurance Authorization Process
Most insurance companies require approval before spine surgery. This is normal.
1
Submission
Our office submits your surgery request with medical records and imaging.
2
Review (5-14 days)
Insurance reviews the request. They may approve, deny, or request more info.
3
Decision
You and our office will be notified.
If Denied
Don't panic. Denials are common and often overturned. We will:
- Review the denial reason
- Submit additional documentation
- Request peer-to-peer review
- File formal appeals if needed
Disability & FMLA
You will likely need time off work. Here's what you need to know.
FMLA (Family Medical Leave Act)
- Job-protected leave up to 12 weeks
- Unpaid (but keeps health insurance)
- Must have worked 1,250+ hours in past year
Short-Term Disability
- Paid leave (60-70% of salary typically)
- Duration: 3-6 months
- Must have policy through employer
Long-Term Disability
- For extended recovery (6+ months)
- Typically 50-60% of salary
⏰ Critical Timing
- Start 3-4 weeks BEFORE surgery
- Forms must be completed before surgery
- Late submissions may delay benefits
- Processing fee applies
- Allow 5-7 business days for completion
What You Need to Do
Contact HR about FMLA and disability
Obtain forms from employer/insurance
Bring forms to office 3 weeks before surgery
Submit completed forms per employer instructions
When to Seek Help
🚨 CALL 911 FOR:
- Loss of bowel/bladder control
- Sudden severe weakness or paralysis
- Chest pain or severe shortness of breath
- Severe headache with neck stiffness
- Loss of consciousness
📞 CALL OUR OFFICE (210-614-6432) FOR:
- Fever over 101.5°F
- Signs of infection (redness, pus, foul odor)
- Clear fluid leaking from incision
- Incision opens or separates
- Sudden increase in pain
- Swelling in one leg
When in doubt, call us.
We'd rather hear from you than have you wait.
210-614-6432
24/7 Emergency Line