What is Spinal Fusion

Spinal fusion is a procedure to make two or more bones in your spine (vertebrae) grow together (fuse). This procedure stops the two bones from rubbing on each other. This can help:

• Lessen pain.
• Prevent your spine from getting weaker or changing shape.

Bone material (graft) will be put in between the spine bones that need to grow together.

What happens before the procedure?

Staying hydrated

Follow instructions from your doctor about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as:
  • Water.
  • Clear fruit juice.
  • Black coffee.
  • Plain tea.

Eating and drinking restrictions

Follow instructions from your doctor about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that have milk in them.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

• Ask your doctor about:
  • Changing or stopping your normal medicines. This is important if you take diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your doctor tells you to take them.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
• You may be given antibiotic medicine to help prevent infection.

General instructions

• Ask your doctor how your surgery site will be marked.
• You will have blood and pee (urine) samples taken.
• You may also have tests that take pictures, such as:
  • X-rays.
  • CT scan.
  • MRI.
• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
• Do not use any products that have nicotine or tobacco in them. These include cigarettes and e-cigarettes. These can make your bones take longer to heal. If you need help quitting, ask your doctor.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
  • Hair may be removed where you will have surgery.
• An IV tube will be put into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to make you fall asleep (general anesthetic).
• If bone from another part of your body is being used to fill the space between the bones of your spine:
  • A surgery cut (incision) will be made over the site of the bone graft.
  • A small part of the bone will be taken out.
• A surgery cut will be made over the spine bones that will be worked on. This cut may be in one of these areas:
  • Your back.
  • Your belly (abdomen).
  • Your side.
• The muscles will be moved over so the doctor can see the bones of your spine.
• If you are having this procedure because a disk in your spine bulges out too far (herniated disk), part of the disk will be taken out.
• The space between the bones of your spine will be filled with one of these:
  • Bone from another part of your body.
  • Bone from someone else (bone donor).
  • Bone that is not real (is artificial).
• Screws and rods or metal plates may be used in the bones. This is to keep the spine bones still while they grow together.
• Your muscles will be moved back into place.
• A small tube (drain) may be put near your surgery cut(s) to help drain extra fluid.
• Your surgery cut(s) will be closed.
• A bandage (dressing) may be used to cover your surgery cut(s).

The procedure may vary among doctors and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be checked until the medicines you were given have worn off.
• You will:
  • Be given medicine for pain if you need it.
  • Keep getting fluids and medicines through an IV tube.
  • Be helped to turn in bed often by “log rolling.” This is when you move your whole body without twisting your back.
  • Be taught how to move the right way and how to stand and walk.
• You may be given a brace to wear while you heal.
• You may have to wear compression stockings. These stockings help to prevent blood clots. They also lessen swelling in your legs.
• Do not drive for 24 hours if you were given a medicine to help you relax.

Summary

• Spinal fusion is a procedure to make two or more of the bones in your spine (vertebrae) grow together (fuse).
• Before the procedure, follow instructions from your doctor about what you can eat, drink, and take for medicine.
• After surgery, you will be helped to turn in bed often without twisting your back. This is called “log rolling.” You will also be taught how to move, stand, and walk the right way.

Spinal Fusion, Adult, Care After

This sheet gives you information about how to care for yourself after your procedure. Your doctor may also give you more specific instructions. If you have problems or questions, contact your doctor.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your doctor. These include any medicines for pain or blood-thinning medicines (anticoagulants).
• If you were prescribed an antibiotic medicine, take it as told by your doctor. Do not stop taking the antibiotic even if you start to feel better.
• Do not drive for 24 hours if you were given a medicine to help you relax (sedative) during your procedure.
• Do not drive or use heavy machinery while taking prescription pain medicine.

If you have a brace:

• Wear the brace as told by your doctor. Take it off only as told by your doctor.
• Keep the brace clean.

Managing pain, stiffness, and swelling

• If directed, put ice on the surgery area:
  • If you have a removable brace, take it off as told by your doctor.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.

Surgery cut care

• Follow instructions from your doctor about how to take care of your cut from surgery (incision). Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If you cannot use soap and water, use hand sanitizer.
  • Change your bandage as told by your doctor.
  • Leave stitches (sutures), skin glue, or skin tape (adhesive) strips in place. They may need to stay in place for 2 weeks or longer. If tape strips get loose and curl up, you may trim the loose edges. Do not remove tape strips completely unless your doctor says it is okay.
• Keep your cut from surgery clean and dry.
  • Do not take baths, swim, or use a hot tub until your doctor says it is okay.
  • Ask your doctor if you can take showers. You may only be allowed to take sponge baths.
• Every day, check your cut from surgery and the area around it for:
  • More redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• If you have a drain tube, follow instructions from your doctor about caring for it. Do not take out the drain tube or any bandages unless your doctor says it is okay.

Physical activity

• Rest and protect your back as much as possible.
• Follow instructions from your doctor about how to move. Use good posture to help your spine heal.
• Do not lift anything that is heavier than 8 lb (3.6 kg), or the limit that you are told, until your doctor says that it is safe.
• Do not twist or bend at the waist until your doctor says it is okay.
• It is best if you:
  • Do not make pushing and pulling motions.
  • Do not sit or lie down in the same position for a long time.
  • Do not raise your hands or arms above your head.
• Return to your normal activities as told by your doctor. Ask your doctor what activities are safe for you. Rest and protect your back as much as you can.
• Do not start to exercise until your doctor says it is okay. Ask your doctor what kinds of exercise you can do to make your back stronger.

General instructions

• To prevent blood clots and lessen swelling in your legs:
  • Wear compression stockings as told.
  • Walk one or more times every few hours as told by your doctor.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your doctor.
• To prevent or treat constipation while you are taking prescription pain medicine, your doctor may suggest that you:
  • Drink enough fluid to keep your pee (urine) pale yellow.
  • Take over-the-counter or prescription medicines.
  • Eat foods that are high in fiber. These include fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.
• Keep all follow-up visits as told by your doctor. This is important.

Contact a doctor if:

• Your pain gets worse.
• Your medicine does not help your pain.
• Your legs or feet get painful or swollen.
• Your cut from surgery is more red, swollen, or painful.
• Your cut from surgery feels warm to the touch.
• You have:
  • Fluid or blood coming from your cut from surgery.
  • Pus or a bad smell coming from your cut from surgery.
  • A fever.
  • Weakness or loss of feeling (numbness) in your legs that is new or getting worse.
  • Trouble controlling when you pee (urinate) or poop (have a bowel movement).
• You feel sick to your stomach (nauseous).
• You throw up (vomit).

Get help right away if:

• Your pain is very bad.
• You have chest pain.
• You have trouble breathing.
• You start to have a cough.

These symptoms may be an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

• After the procedure, it is common to have pain in your back and pain by your surgery cut(s).
• Icing and pain medicines may help to control the pain. Follow directions from your doctor.
• Rest and protect your back as much as possible. Do not twist or bend at the waist.
• Get up and walk one or more times every few hours as told by your doctor.