Post Operative Instructions
Home Recovery
Before you are discharged from the hospital, Dr. Kristof and his team will give you specific
postoperative instructions for you to follow at home depending on the type of surgery you
undergo. This will include any activity restrictions, instructions on the care of surgical
incisions, and medication usage. Following these instructions is crucial to your recovery. If
you are unsure of any of these instructions, ask for clarification.
In general, you can expect your surgical wound to be sore immediately following surgery,
and this should improve day-to-day over the 2-4 postoperative weeks. Your leg or arm pain
may be immediately improved or even gone, or you may continue to experience some pain
for a number of days to weeks. Even if your extremity pain is completely gone after
surgery, you can expect some intermittent pain over the first six weeks after surgery, as the
surrounding tissues heal and inflammation subsides. Do not worry if this happens; it is a
normal occurrence. Severe persistent leg or arm pain should not recur, and should be
reported to Dr. Kristof.
Incision Care
Spinal surgery often involves more than one incision depending on the surgical approach
used to perform the operation. When you are discharged home you may still have a surgical
dressing on your incision. The glue on the skin should be left in place. The glue may get wet
in the shower, but should not be rubbed with a washcloth or a drying towel or it may come
off. Carefully dry this area by patting rather than rubbing. Eventually, the glue will fall off on
its own. Do not bathe or soak the wound site until after the first postoperative visit.
At the time of hospital discharge, your wound is being covered by an outer gauze dressing
held on by clear plastic or white tape, and an inner dressing of white tape strips applied
directly to the skin. You should not shower with the outer dressings on, but instead should
sponge bathe around the incision. During this early recovery period, you will also be
instructed to keep your incision clean and dry, making sure only to use soap and water to
cleanse the area. If there is any drainage from the wound when home, you should keep it
dry, wash around it, and keep it covered with a sterile gauze dressing changed at least
daily. This is especially true if there is any persistent drainage from the wound itself.
The wound stitches (sutures) are absorbable. The ends of the suture may be protruding
from the skin at the ends of the wound. These should be left alone, or covered with a gauze
if they are irritating under the brace. These ends will be removed at the first postoperative
visit if they have not fallen off on their own.
Call Dr. Kristof's office to report any persistent drainage for over two days, to discuss and
receive specific instructions for your particular situation. Antibiotics (such as Keflex or
Clindamycin) may be prescribed for 7-10 days and should be used until finished.
Showering and getting the wound wet is generally permitted once the wound is dry and
without drainage, but the wounds should not be submerged in a tub, pool, or body of water
until it has healed. You should also avoid the use of skin lotions (Vitamin E cream,
bacitracin) in the area of the incision(s) in the early postoperative period; you need to keep
this area dry until it has had the opportunity to heal well.
If you have a brace then it can be removed for the shower and reapplied afterwards. In
some circumstances we will be given strict instructions to keep the brace on at all time
including showering. You may be given a second brace to be used for showering which can
get wet, unless instructed otherwise by Dr. Kristof. If you only have one brace, do not get it
wet; wash around it. You may contact Dr. Kristof’s office to fax or mail a prescription for a
second brace.
In addition to caring for your incision(s), you will also be encouraged to:
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Drink plenty of fluids
Avoid the use of nicotine (cigarettes/cigars, chewing tobacco)
Maintain a healthy diet (high in protein)
Perform deep-breathing exercises regularly
Gradually increase your physical activity
Activities to avoid usually include any heavy lifting, bending, or twisting, although
specific activity instructions in your case should be discussed with Dr. Kristof and
members of his team prior to hospital discharge
Warning signs
If any signs of possible infection are observed, you should call Dr. Kristof's office to check in
with him or a clinical staff member. These signs include
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Fever - a body temperature greater than 101°F (38°C)
Persistent or worsening drainage from the incision(s)
Opening of the incision(s), and
Redness, warmth, or increased tenderness around the incision(s)
In addition, call Dr. Kristof to report any chills, nausea/vomiting, or if you suffer
any type of trauma (e.g., a fall, automobile accident) which may have impacted the
surgical area
Medications
Discharge medications will usually consist of a narcotic pain reliever and/or a muscle
relaxant. Narcotic medications such as Norco or Lortab, Tylenol with Codeine, Vicodin
(hydrocodone/apap), and Percocet (oxycodone/apap). These should be used only as needed
for pain, usually diminishing in need over the first few days after surgery. When you are
comfortable enough, only extra- strength Tylenol (acetaminophen) should be needed.
Avoid the use of Nonsteroidal anti-inflammatory medications such as Motrin (Advil,
ibuprofen), Naprosyn (Aleve), and aspirins should not be used for the first 6-12 weeks after
surgery, as they may adversely affect the healing of the bone fusion.
Physical Therapy/Exercise
In general, patients should be up and walking as much as possible after surgery. This will
help to condition the traumatized muscles and decrease the incidence of complications like
deep venous thrombosis, pulmonary embolism, and pneumonia. I encourage patients to
walk up to 2 miles a day by the time they are six weeks postoperative. Avoid heavy lifting,
bending, or twisting activities over the first 6 weeks after surgery. Lifting should be avoided
- nothing heavier than a filled coffee cup, for six weeks as well. Specific activity instructions
in your case should be discussed with Dr. Kristof and members of his team prior to hospital
discharge.
Outpatient postoperative physical therapy may be prescribed at the first postoperative office
visit if needed. However most patients can exercise at home on their own and do not need
formal physical therapy.
Driving
In general, most patients will be cleared for driving after the two-week postoperative visit.
Return to desk-type work can be allowed 2-6 weeks after surgery, depending on
postoperative symptoms and expected commute. Return to physical labor is usually at 12
weeks after the operation. Resumption of previous recreational physical activities is
generally begun at 12 weeks postoperatively.
Office Visit
During the first few days home, contact Dr. Kristof’s office to schedule your first
postoperative office visit, generally at 2-4 weeks from the time of surgery. If a fusion
surgery was done X-rays are performed just prior to seeing Dr. Kristof. Please be sure to
call Dr. Kristof's office at any time if you have any urgent questions or concerns. There is
always someone from his team covering his patient service at all times, if he is not directly
available to respond.