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About Your Procedure: Posterior Transforaminal Interbody Fusion (TLIF) and/or Posterior Spinal Fusion

Thank you for choosing the Memorial Hermann Mischer Neuroscience Institute at the Texas Medical Center for your neurological care. Following a neurosurgical procedure, you may have questions about your recovery. This information will help answer your questions and provide you with instructions for follow-up care.

Follow-Up Plan: You should follow up with our team in the neurosurgery clinic within two weeks of your procedure. After your discharge, our office will contact you to schedule this appointment.

If you have not received a phone call from our team within one to two business days after discharge, please contact our office at (713) 704-7100.

Diet

You can resume your normal diet unless otherwise directed.

Activity/Restrictions

The more physically active you are, the faster you will get better. You should increase your physical activity daily, including a gentle range of motion. Walking is encouraged and should be done as tolerated to prevent blood clot formation and pneumonia, as well as to sustain previous activity levels. You may return initially to normal light household chores.

  • Avoid excessive, repetitive or abrupt rotation, bending, twisting, tugging, lifting or pulling.
  • Use proper body mechanics (bending your knees, for example) when picking up something from the floor.
  • Do not allow small children or large pets to pull or tug on your arms.
  • Avoid bouncy and/or strenuous activities for at least three months unless otherwise indicated – for example, jumping rope, trampolines, running, riding lawn mowers/tractors and using chain saws.
  • Avoid heavy lifting.

Limitations

  • Limit lifting to 10 pounds for the first four weeks.
  • Do not drive while on pain medication.
  • Do not drink alcohol or use tobacco.

Guidelines

  • You can drive in two to three weeks if you are no longer on pain medication.
  • You may shower.
  • You may wash your hair.
  • You may use the stairs.
  • Depending on job duties, you may return to work anywhere from two weeks to three months following the procedure. Your return-to-work time will be discussed at your initial post-op evaluation.

Special Equipment

Before you are discharged from the hospital, you will be fitted with a brace and provided with instructions on how to wear it. Braces should be worn in the first four to six weeks as tolerated and should be worn when riding in a vehicle and when walking. You do not need to wear the brace when lying in bed unless it provides comfort, and you may shower or sit in a chair to eat without the brace.

Incision Care and Hygiene

You will have staples or sutures in place following surgery. Your dressing should be changed daily for the first five days following the procedure and may be changed when soiled or wet to keep the incision clean and dry. You may shower, but do not take a bath for six to eight weeks following surgery unless instructed otherwise by the office.

When you shower in the first five days following surgery, cover the incision and sutures/staples with waterproof dressing (available at drugstores) or plastic wrap, taping down the sides. If the incision does get wet, pat dry with a clean, dry towel.

When five days have passed since your procedure, you may get the incision and sutures/staples wet and shower (but not bathe) as normal. After showering, pat the incision dry with a clean towel and leave the incision open to air. Do not scrub or pick at the incision. Do not clean the incision with alcohol or peroxide or apply anything else to the incision unless otherwise instructed by our office.

You are advised to call the office if you experience:

  • Excessive bleeding
  • Drainage
  • Redness
  • Swelling
  • A temperature higher than 101.5°F
  • Increasing pain
  • Any other symptom that concerns you

Postoperative Pain and Concerns

You may experience aching, tightness, muscle spasms and/or soreness in the lower back following the procedure. You may also have some mild swelling and bruising across the buttocks. These symptoms can be managed with medications provided at discharge.

It is common to experience constipation after surgery as a side effect from pain medication and anesthesia. To combat this side effect and prevent straining (as this may increase your pain), you will be provided with a prescription for a stool softener, which you should take during hospitalization and upon discharge. If you are still unable to have a bowel movement, are experiencing persistent constipation or have any other concerns, call the office at (713) 704-7100.

You may also experience numbness, tingling, burning or shooting pain in the extremities after surgery. These sensations are normal and may come and go in varying degrees and intensities but should eventually subside. If these symptoms persist or worsen, please call the office.

Physical Therapy

Physical therapy is typically discussed at your two-week follow-up appointment. If physical therapy is required sooner, arrangements will be made prior to discharge. Physical therapy, should you require it, generally commences three to four weeks following surgery.

Medication Instructions

See your medication reconciliation form for instructions. You will probably resume all previous home medications and should follow up with your prescribing physician for additional instructions. Prescriptions will be provided, and may be filled at the hospital-associated pharmacy prior to discharge. Prescriptions are given for pain, constipation and/or muscle spasms. If you require aspirin, you usually may resume taking it within 24 to 48 hours after surgery; please confirm prior to discharge.

Again, thank you for choosing the Mischer Neuroscience Institute. Please contact us at (713) 704-7100 should you have any questions.