How long will my surgery take?

Lumbar discectomy (one level) - about 1 hour (add 1 hour for each additional level)
Lumbar laminectomy (one level) - about 1.5 hours (add 1 hour for each additional level)
Anterior cervical discectomy with fusion - about 1.5 hours (add 1 hour for each additional level)
Posterior fusion - about 1.5 hours (add 1 hour for each additional level)
Lumbar Interbody Fusion - 2 to 4 hours
Craniotomy - For tumors - 2 to 4 hours
                      For hemorrhage - 1 to 2 hours

How long will I be hospitalized?

Lumbar discectomy - Usually 1 day
Lumbar laminectomy - 1 to 2 days
Anterior cervical discectomy with fusion - 1 to 2 days
Lumbar Interbody Fusion - 2 to 4 days
Craniotomy - usually 2-4 days

When can I bathe?

You may shower as long as you keep your incision completely dry. Do not take a tub bath or swim until your staples, sutures, or steristips have been removed- (Usually 7 - 14 days after surgery)

How should I modify my activities after surgery?

We strongly recommend lots of rest the first week after your surgery. You can do most of your typical daily activities. It is OK to take walks and climb stairs after surgery. Avoid lifting objects that weigh over 10 pounds. Avoid aggressive yard work, housework, or other strenuous activities.

When can I return to work?

Returning to work depends on your surgery and the type of work you do. Your surgeon makes the final decision: it's usually four to six weeks after major surgery and a few days following minor surgery.

When can I drive?

You may travel in a car for short trips but do not drive until your doctors tells you it is OK.

Will I require physical therapy?

Not typically; although your surgeon will evaluate your specific case to determine if Physical Therapy is necessary

How long does the pain and swelling last after surgery?

It is normal to have a slightly red, swollen incision. Call your surgeon if you have increased redness, swelling or drainage with an odor. These are possible signs of infection. Take your temperature daily. A slight fever is normal the day after surgery, but call your surgeon if your temperature stays elevated. Your staples or sutures will be removed 7 to 14 days after your surgery.

Will the doctor prescribe pain medication for me?

Our surgeons strive to ensure that your treatment be as comfortable as possible. Therefore, patients who undergo surgery can expect to receive adequate medication to control their pain. The long-term use of narcotic pain medication should not be expected. Individual cases differ, but, as a general rule, expect to receive a prescription for narcotic pain medication upon discharge from the hospital. This prescription will be sufficient to last until your first post-operative visit. At this office visit you can discuss any further medication needs with your surgeon. Please understand that under most circumstances you will be weaned off narcotic medication within 6 weeks of your surgery.

In cases of cervical disc surgery, how long will I need to wear a cervical collar?

Unless your surgery was necessary due to trauma, you will not need to wear a cervical collar. If you were involved in an accident or other trauma requiring cervical disc surgery you may be asked to wear a cervical collar for up to 4 months.

When do I need to come back to see the surgeon after surgery?

You will have a minimum of two post-operative appointments. 7 to 14 days after surgery you will need to make an appointment to have your staples/sutures removed. 4 weeks after your surgery you will return for a post-operative evaluation with the Surgeon or Physician Assistant.

Medications

This is a list of medications commonly prescribe by surgeons and physician assistants in the treatment of Neurosurgical disorders. (Generic names are in parenthesis).

Metropolitan Neurosurgery strives to make your post-operative recovery as painless as possible. Our policies and procedures outlined below help us serve you better.

• Because narcotics require a written prescription we will only prescribe refills during working hours when a physician or PA is in our Coon Rapids office. Generally this is Tuesday, Wednesday, or Thursday.
• We will not refill narcotics in the evenings or on weekends.
• We will generally not prescribe narcotics for longer than 6 weeks after your surgery. At some point we will recommend non-narcotic pain medication.

• When you have 3 to 4 days of your prescription left, call your pharmacy for a refill. Please allow 24 - 48 hours for that prescription to be refilled.
• If your prescription is due to run out on a weekend call your pharmacy before Thursday afternoon to ensure it is refilled by Friday afternoon.
Narcotic prescriptions

• When you have 3 to 4 days of your prescription left, call the clinic for a refill. The physician or PA will evaluate your case. If they approve a refill a written prescription will be completed and you can pick it up at the Coon Rapids office.

Pre-Operative Instructions

Pre-op Examination A patient.s initial appointment with the Neurosurgeon is called a consultation and includes an evaluation of general health, review of the patient.s medical history, findings from X-rays, CT scans, MRI studies and/or other diagnostic tests. It is extremely important to bring any x-rays, MRIs, or CT scans with you to your scheduled appointment and prior to any surgical procedure. You will be asked to complete a brief medical history questionnaire prior to seeing the doctor. You will also be asked to provide a list of any medications that you are currently taking and any allergies that you may have. The preoperative evaluation identifies conditions that could cause surgical complications. Any condition affecting the cardiovascular, pulmonary, musculoskeletal, nervous, gastrointestinal, or endocrine system can increase surgical risk. A clear understanding of these potential problems makes the surgical procedure safer. In some cases, the patient is referred to a medical specialist prior to elective surgery. Pre-op Instructions If you regularly take medication of any kind, including over the counter medication, your doctor may need to make medication changes before or after surgery. Ask your surgeon about taking your regular medications, including aspirin, anti-inflammatory drugs, and Coumadin before surgery. If you smoke you will need to quit one to two days before surgery Your doctor may discuss blood donation with you, in case you need a blood transfusion to replace blood lost during surgery. You may be asked to scrub the area where your incision will be make. If this area has hair, it may be shaved at the hospital. You will probably be admitted to the hospital the day of surgery. Patients who have a scheduled admission will receive a telephone call from the Admitting Department prior to their admission date. You will be given individual instruction regarding how to get ready for the procedure. Bring your insurance cards or forms with you to the hospital. You will be instructed not to eat or drink anything after midnight the night before surgery. Your surgery may be cancelled if you do eat or drink after midnight. This is due to higher risk of vomiting and breathing stomach contents into your lungs during surgery. Before you have surgery, you will be asked to sign a surgery consent form. It is important that you talk to your doctor about any questions or concerns that you or your family may have regarding your surgical care. Leave your valuables, such as watches and jewelry, at home Remove makeup before surgery, especially nail polish and lipstick. The surgical staff needs to see your natural coloring. Remove dentures, glasses and contacts before surgery. Bring any recent test results. Inpatients: Bring your personal toiletries and pajamas, robe, and slippers for your own comfort after surgery. Also, bring your medication list (name, dose, how often you take them.) Post-Op Instructions Resume activity gradually and do not overexert yourself Avoid prolonged sitting. Get up and walk around. Short trips are better than long ones right after surgery. Climbing stairs is not restricted. You may travel in a car for short trips but do not drive until your doctor tells you it is OK. Do not lift or carry anything that is heavier than 10 pounds. When picking up an object from the floor, bend with your knees, keeping your back straight using both hands to hold the object close to your body. Constipation is a common side effect of some pain medications so it is important to drink plenty of liquids and eat a diet high in fiber. You may need to take a stool softener for a short time while taking pain medication, but avoid laxative. It is fine to take Milk of magnesia, Metamucil, Fibercon, Citrocel or other mild laxatives. Ask your pharmacist for advice if needed. Avoid stronger laxatives unless your surgeon has prescribed them for you. It is normal to have a slightly red, swollen incision. But, call your surgeon if you have increased redness, swelling or drainage, or if you notice an odor from your incision. Call your surgeon if you are having difficulty urinating or if you develop a fever over 100 degrees F after your discharge to home. Pain medication allows you to be up and around more comfortably. This helps healing and prevents post-operative complications. Take pain medication as directed (usually every 4-6 hours) before pain becomes severe. Don.t take the medication more often than directed. Taken as directed, medication won.t lead to addiction during recovery. Taking pain medication at night helps you get a goo night.s sleep. If you are taking muscle relaxers, separate the pain medication from the muscle relaxer by 1-2 hours for better pain relief. The level of surgical discomfort should improve of the the first few days and weeks after hospital discharge as the irritation and swelling of damaged nerves and muscles heal. Call your surgeon if you notice any increase in pain, decrease in your ability to move, numbness or tingling. Avoid drinking alcohol while taking pain medication. Mixing pain medication and alcohol can lead to serious complication and is sometimes fatal. Avoid driving while taking pain medication. Check with your surgeon before taking any over the counter drugs or medications not specifically ordered by him/her after surgery. Be sure to follow any specific post-op instructions from your surgeon or nurse.