Preparation Before Spine Surgery

Patient Guide

Preparing for Spine Surgery

Proper preparation before spine surgery plays a vital role in improving surgical safety, reducing the risk of complications, and promoting a faster recovery. Please read the following information carefully. If you have any questions, do not hesitate to discuss them with your surgeon or healthcare team.

Preoperative Medical Evaluation

• Complete all requested laboratory tests, electrocardiogram (ECG), and imaging studies as instructed by your physician.
• Bring all previous MRI scans, CT scans, X-rays, and relevant medical records on the day of admission.
• Inform your surgeon about any underlying medical conditions such as diabetes, high blood pressure, heart disease, kidney disease, or lung disease.
• Tell your healthcare team about any previous spine surgery or other major surgical procedures.

Medications

• Bring an updated list of all medications you are currently taking, including prescription drugs, over-the-counter medications, vitamins, and herbal supplements.
• Only stop or continue medications according to your surgeon's instructions.
• Blood-thinning medications such as Warfarin, Rivaroxaban, Apixaban, Dabigatran, Clopidogrel, and Aspirin may need to be discontinued temporarily before surgery.
• Do not start or stop any medication without consulting your treating physician.

Drug and Material Allergies

Please inform your healthcare team if you have any allergies to medications, latex, adhesive tapes, antiseptic solutions, or contrast agents.

Nutrition, Fasting, and Preparing for Surgery Day

Following the recommended dietary instructions before surgery helps reduce anesthesia-related risks and contributes to a safer surgical procedure.

Fasting Before Surgery

• Do not eat or drink after the time specified by your surgeon or hospital.
• In most cases, patients should not eat after midnight before surgery; however, the specific instructions provided by your surgeon or anesthesiologist always take priority.
• If you accidentally eat or drink during the fasting period, notify the medical staff immediately before surgery.

Healthy Nutrition Before Surgery

• Maintain a balanced diet rich in protein, fruits, and vegetables in the days leading up to surgery.
• Drink adequate fluids unless your physician has instructed otherwise.
• If you have diabetes, follow your physician's recommendations regarding your diet and medications.

Smoking, Hookah, and Alcohol

• If possible, stop smoking or using hookah several weeks before surgery.
• Tobacco use significantly increases the risk of infection, delayed wound healing, poor bone fusion, and reduced surgical success.
• If you consume alcohol regularly, discuss this with your physician before surgery.

Personal Hygiene

• Take a shower the evening before or the morning of surgery.
• Keep the surgical area clean and avoid applying lotions, creams, oils, perfumes, or cosmetics.
• If hair removal is necessary, it will be performed by the healthcare team. Please do not shave the surgical area yourself.

What to Bring to the Hospital

• Identification and insurance documents
• All MRI scans, CT scans, X-rays, and other relevant imaging studies
• Laboratory reports and other important medical records
• A complete list of your current medications
• Essential personal items such as eyeglasses, hearing aids, or removable dentures if applicable

Hospital Admission and the Day of Surgery

On the day of your surgery, your healthcare team will guide you through each step of the process. Understanding what to expect often helps reduce anxiety and allows you to feel more prepared.

Hospital Admission

• Arrive at the hospital at the scheduled admission time.
• Bring your identification, insurance information, imaging studies, laboratory results, and all requested medical documents.
• Inform your healthcare team if you develop fever, cold symptoms, cough, shortness of breath, or signs of infection before surgery.

Preoperative Preparation

• Your vital signs, including blood pressure, heart rate, temperature, and oxygen level, will be checked.
• An intravenous (IV) line will be inserted for fluids and medications.
• Your anesthesiologist may perform a final evaluation and answer any remaining questions.
• The surgical site will be verified and marked according to established patient safety protocols.

Anesthesia

Most spine procedures are performed under general anesthesia. Throughout the operation, the anesthesia team continuously monitors your heart function, breathing, blood pressure, oxygen level, and other vital signs to ensure maximum safety.

Before Entering the Operating Room

• Remove all jewelry, watches, contact lenses, hearing aids, removable dentures, and other personal belongings as instructed.
• Discuss any remaining questions or concerns with your surgeon or nursing staff.
• Before surgery begins, your identity, planned procedure, and surgical site will be confirmed according to international patient safety standards.

Managing Preoperative Anxiety

• Feeling anxious before surgery is completely normal.
• If you experience significant anxiety, discuss it with your surgeon or anesthesiologist. Medication can be provided if necessary.
• Be assured that your procedure will be performed by an experienced surgical team following internationally accepted safety protocols.

Informed Consent, Early Recovery, and Final Recommendations

The primary goals of spine surgery are to relieve pain, improve function, preserve or restore neurological function, and enhance quality of life. Like all surgical procedures, spine surgery carries potential risks and complications. Before surgery, your surgeon will explain the expected benefits, possible limitations, treatment options, and potential risks so that you can make an informed decision.

Immediately After Surgery

• After surgery, you will be transferred to the recovery room, where your vital signs will be closely monitored.
• Once your condition is stable, you will be transferred to your hospital room.
• Mild pain, drowsiness, sore throat, or nausea after anesthesia are common and are usually well controlled with appropriate treatment.
• Your surgical team will regularly evaluate your neurological function, including strength and sensation in your arms and legs.

Early Mobilization

• Following many spine procedures, walking is encouraged on the day of surgery or the following day, depending on your condition.
• Early mobilization reduces the risk of blood clots and other postoperative complications.
• The timing and level of activity vary depending on the type of surgery and your individual condition. Always follow your surgeon's recommendations.

Hospital Discharge

• Your discharge date depends on your overall recovery and the type of procedure performed.
• Before discharge, you will receive detailed instructions regarding medications, wound care, activity restrictions, and follow-up appointments.
• Keep your prescriptions and discharge instructions readily available for future reference.

Warning Signs After Discharge

Please contact your surgeon or seek medical attention immediately if you experience any of the following:

• Fever higher than 38°C (100.4°F)
• Increasing redness, swelling, or drainage from the surgical wound
• Severe pain that is not relieved by prescribed medication
• New or worsening weakness in the arms or legs
• Loss of bladder or bowel control
• Progressive numbness
• Chest pain, shortness of breath, or sudden swelling of the calf

Follow-Up Appointments

• Follow-up visits are an essential part of your recovery and should not be missed.
• If requested, complete your follow-up X-rays, CT scans, or MRI examinations on schedule.
• Do not change your medications or resume strenuous activities unless approved by your surgeon.

We wish you a safe surgery, a smooth recovery, and a rapid return to your daily life.

Dr. Nima Ostadrahimi
Neurosurgeon
Spine Fellowship Trained Surgeon
Assistant Professor, Tehran University of Medical Sciences