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General Surgical Instructions

Please have a responsible adult with you for the first 24 hours after surgery.


  • You will need to obtain a bottle of Hibiclens soap from your pharmacy. It can be purchased over the counter. You will need to wash with this soap within 24 hours prior to surgery. Use this soap on your entire body, the night before OR the morning of surgery. Pay particular attention to your surgical area. Avoid face and genitals (internal contact).
  • You will be issued a prescription for Mupirocin nasal ointment. This ointment is an antibiotic that is used twice daily for 5 days prior to surgery. This is a preventative measure to clean out your system prior to your scheduled procedure. Please bring the remaining medication on the day of surgery. You will need a dose the morning of surgery and they will charge you for a new tube otherwise. This medication is only used if you are having a device, such as hardware, implanted. See directions on prescription.
  • Gabapentin will be prescribed. Please take 300mg the day before surgery and continue taking 300mg twice daily following surgery until the prescription runs out. If you already take Gabapentin, Lyrica or Topamax, continue with your normal dosing.
  • If you were given a back or neck brace, please take it with you to your date of surgery.
  • Please alert the staff if you take any blood thinners or take immunosuppressant drugs. e. Coumadin, Eliquis, Plavix, Aspirin, Humira, Stelara, Methotrexate.
  • Please alert the staff if you take Suboxone, Buprenorphine, Belbuca, or Butrans.
  • Please alert the staff if you have had any recent infections, illnesses, or hospitalizations.
doctor looking at spinal x-ray

Day of Surgery

  • Celebrex 200mg will be given the morning of surgery at the facility. Please alert us if you are unable to take NSAID’s or anti-inflammatory medication.
  • Tylenol 500mg x2 tablets will be given the morning of surgery at the facility. Please alert us if you are unable to take Tylenol.


  • Take pain medications as needed per the prescription directions. Keep in mind it could take the medicine as much as 60 minutes to start providing relief, prepare accordingly.
  • New State laws will not allow narcotics to be filled beyond a 7 day supply. Refills will not be permitted without a scheduled office visit. Please plan ahead if refills will be needed.
  • Pain medications are always very constipating. Please use Miralax (1 cap dissolved in liquid 1-3x/day) & Senokot 1-2 tabs, 1-3x/day) if needed. If this combination is not effective, or you have not had a bowel movement for 3 days, please contact the office.
  • All medications should be taken with food unless otherwise instructed.
  • Do not drive or operate hazardous machinery, make critical decisions, drink alcoholic beverages, or take sedating medications while taking pain medications or muscle relaxers.
  • Cervical Artificial Disc Replacements only: You will be issued Naproxen to be taken twice daily for 2 weeks following surgery. Please complete the full course of the prescription.


  • DO NOT force food or liquids.
  • When you are thirsty, drink small amounts of non-caffeinated and non-alcoholic drinks frequently.
  • When you are hungry, eat food that is easily digestible.
  • For neck patients, drink Boost or Ensure, or consume liquid or soft foods such as soup for the first few days if there is difficulty swallowing. This typically improves within a few days.


  • Your next appointment should be approximately 10 days post operative for staple removal, or incision check.
  • The follow-up schedule will be 6 weeks, 3 months, 6 months and 1 year post operative.
various x-rays of spines

Report the Following Conditions to Your Physician

  • If you are sick to your stomach or vomiting more than 4-6 hours
  • A fever over 101°F, chills or night sweats
  • If your incision becomes red, swollen, shows pus or feels increasingly sore as the days pass
  • If there is an increase in swelling, numbness, tingling and/or discoloration
  • Painful, swollen, or red calf or leg
  • Shortness of breath or chest pain (call 911 if symptoms persist)
  • No bowel movement for 3 days

General Instructions

  • The facility where your surgery is to be performed will call you at least 24 hours prior to your surgery to inform you of your check-in time and details regarding your surgery.
  • Please make sure to wash your hands thoroughly with antibacterial soap before dressing changes.
  • Change the dressing as needed.
  • A small amount of bleeding is normal.
  • No bathing or hot tub for 3 weeks or until wound is COMPLETELY healed.
  • Your incision must be covered with a water-proof dressing while showering.
  • NO lotions or creams, including over-the-counter antibacterial ointments on the incision.
  • If your insurance covers it, home health care may be advised. You will be contacted by a home health agency if applicable. Home health is a very nice option if covered by insurance, but it is optional and may be declined at your discretion.


  • No bending, twisting, straining or lifting more than 5-10 pounds for 6 weeks.
  • Walk and perform other normal activities as tolerated.
  • Wear provided bracing as needed.
  • If you are having a multi-level fusion, or meet certain criteria, you may be contacted to wear a bone growth stimulator. A representative from the providing company will call you directly for arrangements.
  • Post-surgical inflammation may cause symptoms similar to pre-surgical. This will normally resolve within 6 weeks and is not uncommon or cause for concern, however if symptoms persist; contact your physician.

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