Most surgeons provide their patients with preoperative instructions, which include a recommendation for preoperative testing, directions as to where to go, when to arrive, and what to expect. There may be additional directives such as changing the dosage and/or utilization of certain medications. Some medications are known to increase the potential for bleeding or alter surgical outcome. The use of certain medications may have to be discontinued many weeks prior to surgery. Your attending surgeon should recommend that you discontinue using alcohol and quit smoking for an appropriate period of time prior to surgery to reduce the risk for complications.

Your attending surgeon will likely recommend that you receive a pre-operative workup with your family physician or internist who has privileges in the hospital where the operation is scheduled. Principal health concerns include underlying cardiovascular disease, blood sugar abnormalities, clotting times and autoimmune disease. The attending physician or internist will also be asked to provide medical clearance to the spine specialist prior to surgery. The internist may also call upon other specialty consultations such as cardiology or endocrinology to further evaluate the patient’s health conditions prior to surgical intervention and prior to providing clearance for surgery.

Immediately prior to surgery, you will be advised what to eat and what not to eat. Vitamins are discontinued at least five days before surgery to avoid interaction with medication or reduce the chance of increased bleeding. In general, most patients are advised to eat nothing after midnight to reduce the risk for vomiting and lung aspiration. For this reason, most spine operations are performed earlier in the day.

What You Should Know About Spine Surgery?

What happens during the weeks and days before the spinal surgery can significantly influence the outcome of back surgery. During this time, numerous things need to take place including confirmation of the diagnosis, a cardiovascular evaluation to rule out complicating factors. Additionally, the surgeon or staff will review therapeutic options, discuss the surgical procedure, and review the informed consent.

The informed consent process should include a discussion as well as the use of a specialized form referred to as a consent form. The discussion should clarify the type of surgical approach to be performed. Included in the informed consent process should be a discussion of any unusual or specialized steps required on behalf of the patient.

The informed consent may include a discussion of any aspects of the proposed procedure that is experimental or not fully cleared by the FDA. This should also be clearly expressed in the consent form. The consent form will include discussion that elaborates on potential complications and emergencies associated with the procedure. The consent form will need to be signed and dated by the patient as well as the attending surgeon.

Learn the Risks, Review the Options, and Confirm the Indications:

The decision to undergo any procedure is based on fact that the benefit substantially outweighs the risk. Some risk factors are considered general to surgery whereas others are very specific to the procedure. Examples of general surgical risks include adverse reaction to anesthesia, excessive bleeding, the development of scar tissue, infection, stroke, and the chance of death. Your attending spine surgeon may be aware of unique risks associated with the technique that he or she has chosen to use. Risks specifically associated with procedures include pedicle screw failure, fusion failure, kyphoplasty failure, etc. The surgeon should be able to provide an answer for the likelihood of each risk based on a review of the literature and his or her personal experience.

The discussion of reasonable alternative options should not be limited to any specific healthcare discipline, but should include those approaches that have been shown to have positive outcome.