One to Four Weeks After Spine Fusion Surgery

Patients usually begin to feel a little stronger each day at this point, but need to be aware of infection risks and medication safety issues.

Wound infections are most likely at about 10 days after surgery. Some symptoms to look for include:

  • Fever (101 degrees or higher)
  • Expanding redness at the incision site
  • Increasing pain
  • Change in the amount, appearance, or odor of drainage

If these signs appear, it is important to contact the treating surgeon immediately.

A patient who develops an infection is typically treated with a long course (usually 4 to 6 weeks) of intravenous antibiotics. Further surgery may or may not be needed. If the infection becomes chronic, the hardware inserted during the surgery may need to be removed.

Incision Healing

To keep the incision clean, it’s important to wash the site with soap and water at least once a day and pat it dry. Ointment is not recommended. Showers are the best option; baths should be avoided until the first postoperative appointment with the surgeon. Any stitches or staples used to close the surgical incision will usually removed about two weeks after surgery.

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Medication Transition

If a narcotic pain medication was prescribed, the patient should wean him or herself from the medication gradually over a few weeks. The surgeon should provide instructions and guidance to help this process.

There is usually no need for narcotics after about two weeks to one month.

The shift away from narcotic pain medications requires the patient to be aware of some pros and cons of other pain relief options.

  • Acetaminophen (e.g. Tylenol). Acetaminophen is considered a relatively safe and effective pain medication and can be used when weaning off narcotic analgesics. It’s important to monitor dosages closely, however, to avoid liver damage. Because it affects the liver, people who drink alcohol should be especially careful to understand the potential risks of acetaminophen before taking any. There is also a risk of accidentally taking too much acetaminophen because it is an ingredient in many over-the-counter and prescription medications. The daily dose should not exceed 4000 milligrams.
  • Potential complications of NSAIDs. Avoiding aspirin products and NSAIDs, such as ibuprofen, naproxen, or COX-2 inhibitors—including brand names Motrin, Advil, Aleve, and Celebrex—for at least three months after lumbar fusion is usually recommended. These products tend to interfere with growth and development of the bone fusion. In some situations, though, these products may be necessary for treatment of other health conditions.

It is important to discuss one's personal situation and all medications with the surgeon and primary care provider and/or pharmacist.

Exercise Plays Major Role

Walking is the ideal form of exercise during this period. Not only does it increase muscle strength, it helps the heart, lungs, and digestive system. Gradually increasing the amount of walking, and stopping when there is added pain, is the best approach. The surgeon may also recommend other exercises.

Moving around as much as is comfortable puts the patient in good position for the next step in recovery, which often includes outpatient physical therapy and driving.