Optimizing the entire cycle of care

Spine surgery is a journey

A well executed spinal operation consists of a number of different steps.

Preoperative Testing

Morning of Surgery

In the OR

Recovery & Rehab

"Success is based on not only the operation itself, but the preparation before surgery and rehabilitation process after surgery. That's the way to maximize the benefit of the operation itself.”
Dr. Shaleen Vira

Guiding you through the Journey

Questions and Answers

Once you decide to have surgery our surgical team will coordinate your day of surgery, and schedule preoperative appointments for medical clearance. These usually include:

  • Laboratory Data

  • Chest X-Ray

  • Electrocardiogram (EKG)

  • History and Physical by Primary Care Physician

  • Specialty Clearance if necessary (Cardiologist)

On the morning of surgery, you are checked in by the nursing team.

– The ​anesthesiologists will introduce themselves and explain what to expect prior to going in the operating room.

– The Operating Nurses will speak to you. The first level of safety is that your incision is marked by the surgeon prior to entering the operating room

– The neuromonitoring team, if used in your surgery, place leads on your skin for monitoring the nerves and spinal cord during surgery

In the operating room you are put to sleep by the anesthesiologist.  After Dr. Vira completes the surgery, anesthesia is stopped and you awake before going to the recovery room.

Patients spend at least 45 minutes in the recovery room prior to going to their assigned hospital bed for postoperative care. Some patients who require additional care go to the step down unit or ICU if necessary.

After surgery, you will find yourself to be very tired and in some pain. You will be spending time resting. Based on what surgery you have, Dr. Vira will recommend that you attempt to sit up and stand up the night of surgery. You will be able to go to the bathroom and manage your surroundings.

You will most likely be using pain medications on a routine basis. 

The discharge process begins the moment your surgery is done. Depending on the level of care, patients will either go home or to a rehabilitation facility. Typically, patients go home within 48 hours of surgery, again, depending on the complexity of your procedure. Prior to discharge, all medications are determined including pain medications and muscle relaxants.

It is a good idea to have someone available to help you for the first two weeks or so at home.

Activities at this point should include a progressive walking program. Use of a stationary bicycle or treadmills are also allowed, although it may be too early to begin this program as of yet. Do what you feel you can do, but be conservative and safe. In any event, no lifting of greater than 10 pounds is allowed. Also, no stooping, twisting, lifting, housework, or yardwork are allowed at this time. A return to sexual activity may occur when you feel ready.

During this period of time, the wound must be kept clean and dry. It is recommended to keep a dry 4×4 inch gauze over the incision at all times. This dressing should be changed on a daily basis. Cover the wound with a cut piece of Saran wrap, secured with tape, for showering purposes. This will keep the incision dry during this process. Change this to a dry gauze once again after the shower. Place no lotions, powders, or ointments on the incision unless instructed to do so.

Keep track of your prescription medications. Write down a schedule as to when they may need to be taken. Please remember, narcotic pain medications usually require the actual written prescription. Do not wait until you are entirely out of medication to call the office for a refill. A 3 to 4 day warning to our office of your refill needs will make the whole process run more smoothly.

As the weeks progress, you can gradually increase your amount of activity however, your restrictions do not change at this point. Returning to work is based on your type of surgery, type of work, level of energy, and general comfort. In general, a laminectomy surgery allows you to return to a sedentary type of job within two weeks. A more involved fusion surgery combined with more physical types of work may require up to two or three months of recovery prior to returning to work.

While you are in the hospital, a member of Dr. Vira’s team is available at all times for your needs. After you are discharged from the hospital, please leave a message with the hospital’s answering service and a member of Dr. Vira’s team will return your call promptly.