Pre-Operative Information

Lumbar Spine Fusion

Preparing For Surgery

There are important steps to follow prior to your surgery to ensure you are prepared for your surgical procedure. Below is a list of things which need to be completed before your surgery date.

  1. Pre-Operative Lab work
    1. You will be given a prescription for lab work to be completed within 1 month prior to your surgery date
    2. This lab work may be done at the hospital, or through your primary care physician
    3. Please ensure the results of this lab work are faxed to Dr. Mazahery's office at 703-810-5420
  2. Medical Clearance
    1. You may need medical clearance from your primary care physician within 1 month prior to your surgery date
    2. Please ensure your medical clearance is faxed to Dr. Mazahery's office at 703-810-5420
  3. Pre-Operative Hospital Interview
    1. The pre-operative department at the hospital will review your medical history with you. This may be done as a phone interview, or you may need to schedule an appointment to visit the pre-op department at the hospital.
    2. This pre-operative interview should be completed after you have seen your primary care physician. Call the hospital to schedule this appointment. Call Reston Hospital at 703-689-9005 Option #1 or Fairfax Hospital at (703) 970-6565.

During this time it is also important to consider the amount of time you will need off work after your procedure and discuss this with your employer. It is also important to plan ahead for what help you may need at home after surgery and discuss this with family and friends. Arranging this prior to surgery will help you be able to focus on your recovery post-operatively.

As your surgery date is approaching, review this checklist to ensure all the steps are completed.

2 Weeks Before Surgery:

  • Pre-Operative Lab work Completed/Scheduled __________
  • Pre-Operative Medical Clearance Completed/Scheduled __________
  • Pre-Operative Interview with Hospital Scheduled __________

    You will need to have a nasal swab pre-operatively to screen for MRSA/MSSA. This will be arranged through the pre-operative department at the hospital

1 Week Before Surgery:

  • Stop taking Aspirin and antiplatelet medications, such as Plavix. Stop taking anti-inflammatories (such as Advil, Ibuprofen, Aleve, Motrin, Voltaren, etc.) __________
  • If Aspirin or antiplatelet medication is prescribed by your doctor, please consult this physician prior to stopping to make sure this is appropriate. __________

2 Days Before Surgery:

  • Check with the hospital for arrival time day of surgery _________

Night Before Surgery:

  • Do not eat or drink anything past midnight unless otherwise instructed by the anesthesiologist __________
  • You will shower with a soap called Hibiclens the night before your surgery. This will be given to you by the hospital.__________

What to Expect During Your Hospital Stay

Day of Surgery:
  1. Remember to bring your MRI if you did not leave it at the office prior to surgery
  2. Registration at the hospital
    1. The hospital will direct you where to go for registration
  3. Pre-Op Holding
    1. In pre-op holding you will be given a gown to change in to and given a bag for your personal belongings. You will meet your holding nurse who will review your chart and start your IV. You will also meet with your surgical team including the anesthesiologist, nurse anesthetist, and surgical nurse. You will see Dr. Mazahery prior to your surgery. Your family member can stay with you until you are transferred to the operating room.
  4. Operating Room
    1. You will be taken to the operating room. Your family will be directed to the waiting room. Dr. Mazahery will meet them there when your surgery is complete.
  5. Recovery Room
    1. When your surgery is complete you will be transferred to the recovery room to be monitored. You are typically here for 1 to 2 hours. If you are having a same day surgery, you will then be transferred to secondary recovery, and your family will be notified when they can see you. If you are being admitted to the hospital, you will be transferred to your room and your family will see you at that time.

What to Expect During Your Hospital Stay

Hospital Post Operative Day #1:

Pain Management- After surgery, if you stay overnight in the hospital, you will be given a PCA (patient controlled analgesia). This is IV pain medication that you are able to control by pushing a button to receive a dose of pain medication when you are feeling pain. This will be started after your surgery and will continue through your first or second day post-operatively. You will then be switched to oral pain medications, to ensure you tolerate these medications prior to your discharge home.

Physical Therapy- We strongly encourage early mobilization after surgery to help with your recovery. Your first session of physical therapy will start on post-operative day #1. The physical therapist will help you mobilize safely. You will be shown techniques to get in and out of bed and chairs, how to use a walker, and mobilize in the hallway and stairs.

Drain- You may have a drain in your incision post-operatively to help prevent fluid from collecting at the surgical site. This is not used in every surgery, and is typically removed on post-operative day #1 or #2.

Foley Catheter- You may have a foley catheter placed in your bladder during surgery to help prevent urinary retention. This is typically removed on post-operative day #1 or #2.

Hospital Post Operative Day #2 and #3:

Physical Therapy- You will have another session of physical therapy encouraging walking in the hallways and safety going up and down stairs.

Discharge planning- We will arrange what devices you may need at home, such as a walker, and have them available for you to take with you. Some patients will need to go to a rehabilitation facility for additional physical therapy prior to going home. You will meet with the social worker to arrange this.

Home Medications- You will be instructed what home medications to resume or discontinue. You will be given prescriptions for pain medication to take at home.

Expected Length of Hospital Stay:

The amount of time you will be in the hospital depends on your individual surgery and post-operative recovery. Typical lengths of stay in the hospital are as follows:

Lumbar Discectomy- Same day discharge

Lumbar Laminectomy- 1 to 2 days

Lumbar Fusion- 2 to 3 days (may be less for minimally invasive surgery)