Laminectomy/Discectomy Post-operative Instructions

Note: Please Contact the Office if:

• Increasing pain or drainage
• Fevers, chills, sweats
• Weakness

Office Phone:  954-530-4344

SouthFloridaBackSpineandScoliosis.com

Activity

1. After your discharge from the hospital and until you have had your first post-operative appointment with Dr. Hepler, avoid all activity except walking.
2. No lifting anything weighing more than a coffee cup.  This restriction will be in force until your first post-op visit (7-10 days after surgery) with Dr. Hepler.
3. No bending or twisting of the back. Wear a lumbar corsette/abdominal binder as a reminder to avoid these activities.
4. No heavy housework or yardwork.
5. You may go up and down the stairs, taking one step at a time and always using the handrail.  
6. The first week after your surgery your priority is to REST.  No exercising except WALKING.  You should start taking short, frequent walks daily, after the first week.  Staying in bed all the time is not good for you.  You may walk outdoors as soon as you feel ready.  You should begin to gradually increase your walking as you can comfortably do so.
7. You may resume sexual relations whenever it is comfortable for you to do so.

Daily Activity Guidelines

The progress of your recovery and your activity guidelines are very individualized.  Every patient is different.  It is important that progress be gradual.  If you experience increased pain after or with walking, reduce the time and distance you are walking.

1. Walking should be done at a comfortable, even pace.  You should never hurry or rush.  Be patient with yourself and remember that proper healing takes time.
2. Frequent, short walks will rebuild your strength and endurance more rapidly than trying to walk long distances right away.  Start walking 2-3 times a day.  
3. When you first arrive home, begin with five minute walks around the house every hour as tolerated.
4. Walk on level surfaces: be cautious walking out of doors due to slippery or adverse weather conditions, especially during the winter months.
5. Wear good walking shoes.
6. Stairs are okay as long as you are careful of your footing.  Take one stair at a time and always hold onto the handrail.

Pain

1. Do not become discouraged if some back and/or leg pain or numbness persists for a while after surgery.  The healing process occurs slowly and can take as long as a year for some nerve injuries.
2. You may use an anti-inflammatory (Naproxen, ibuprofen, meloxicam, diclofenac, Celebrex) for pain if approved by your internist. You will be given a prescription for narcotic pain medication which can be used in addition to an anti-inflammatory. Remember to use it only as prescribed.  Narcotic pain medication may cause constipation.  Drink as much water as you can possibly tolerate, and an over the counter stool softner (Metamucil, dulcolax) may be helpful.
3. Pain medication refills require paper prescription and only given in person in the office.  Do not wait until you run out before you return for a refill. Plan your follow up at least 3-5 days before you might run out. Don’t wait until the last minute or weekend, the pharmacy will not take a refill over the phone
4. You may use an icepack over your incision to decrease swelling and discomfort 2-3 times per day for the first few days after surgery.

Incision Care

1. Your incisions are closed with sutures which are absorbable and steri-strips which are placed over the incisions. The dressing should be changed daily at which time you can examine the incision. It is not uncommon to have some swelling, bruising, tenderness, or small amounts of drainage around the incision after surgery but these changes should improve with each passing day. If they do not improve or worsen contact Dr Hepler’s office and plan on coming to the office for a re-examination. Otherwise, you should have scheduled a follow visit 7-10 days after surgery.
2. Please keep your incision clean and dry until your first post-operative visit with Dr. Hepler.  You may shower with a sealed dressing but protect the incision from any direct exposure to the shower or water.  Do not soak the wound (bathtubs/pool) for a minimum of 4-6 weeks after surgery.
3. Please notify Dr. Hepler’s nurse if you notice any increasing pain, redness, abnormal drainage from the incision or a temperature greater than 101.5.

Icebag

Mix the below ingredients together.  Divide the mixture into the ziplock bags equally and freeze them until the mixture turns to slush.  Place a towel next to your skin, then apply ice to the area.  Use 4 times a day for 15 minutes.  You may re-use the ice-packs.  

1. 3 cups of water
2. 1 cup of rubbing alcohol
3. 2 quart size zip-lock bags

Other Important Information

1. The use of tobacco can impair or retard the healing process and increase infection rates. Smoking should be discontinued as long before surgery as possible.
2. Contact the office if you develop a temperature of 101 degrees or greater, any change in your incision (such as inflammation, redness, swelling, or excessive drainage), pain that is not relieved by rest, ice packs and your pain medication, or if you have any questions or concerns.
3. Contact the office if you develop headaches, new leg/arm pain, numbness, tingling or weakness.

Incision Healing

The incision from microdiscectomy and laminectomy usually heal within 3-6 weeks. You should have a scheduled follow-up at this time to confirm healing and schedule physical therapy to begin a rehabilitative exercise regimen involving range of motion and strengthening exercises. You can also use the exercise of the spine and cervical exercise handouts and the exercise video to assist in you post operative exercise regimen.

Back Rehabilitation

Most disc herniations require 8-12 weeks to heal and excessive activities during this time frame risk causing recurrent injury and pain. In addition the pain and disability associated with disc herniations result in significant core and aerobic deconditioning. Most patients therefore require 3-6 weeks of range of motion and strengthening exercises after healing  before resuming normal activity without restrictions. Patients with more activity demands such as manual laborers and workers compensation patients may require more extensive rehabilitative efforts. View other resources.

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