How to Prepare for Spine Surgery: A Neurosurgeon's Six-Week Checklist

Most planned spine operations follow a predictable runway. About six weeks out is when medical optimization begins — stopping nicotine, tightening control of chronic conditions, and scheduling any clearances your surgeon requests. Around two weeks out the focus shifts to logistics: preparing your home and confirming who will drive you and help you in the first days. The final week is for finishing pre-op testing, following your team's medication-hold instructions, and confirming your arrival time. This guide walks each stage in the same order we use with patients in Topeka; your surgical team's specific instructions always take priority over anything written here.

Nicotine in any form — cigarettes, vaping, chew, or patches — interferes with bone healing and fusion, and stopping well before surgery matters. If you have diabetes, high blood pressure, sleep apnea, or heart or lung disease, this is the window to get those conditions as well controlled as possible and to complete any clearance visits your surgeon requests. If you have upcoming dental work, ask your surgeon whether it should be finished beforehand. None of this has to happen alone — your primary care doctor and surgical team coordinate it with you.

We help arrange a visit with our hospitalist doctors, anesthesia team, and pharmacy team to address all medical, medication, and pre-surgery issues in a coordinated fashion. If additional appointments are needed — for example, cardiology appointments or additional testing — we identify those issues and assist with scheduling. Our surgery scheduler will walk you through the details when your surgery is scheduled, but this appointment is vital for safe and successful surgery.

Bring a complete, current list of everything you take — prescriptions, over-the-counter medicines, vitamins, and supplements — to your pre-op visit. Blood thinners and antiplatelet medicines need specific, individualized handling that a separate guide covers in depth; the essential rule is that you never stop one on your own without instruction from the doctor who prescribed it. GLP-1 medications used for diabetes or weight loss have their own pre-surgery considerations your team and anesthesiologist will review. Many surgeons also ask patients to hold certain supplements and anti-inflammatory medicines. This hub does not list hold times on purpose — those belong to your surgical team and prescriber.

Set up a recovery space before surgery, not after. That usually means a comfortable place to rest with easy access to a bathroom, frequently used items within reach so you avoid bending or twisting, and clear, uncluttered walking paths. Arrange your helper in advance — someone who can drive you home, be present for the first day or two, and assist with meals and household tasks while you focus on walking and rest. Thinking through these details early removes a lot of stress from the days right after surgery.

Your team will give you specific instructions about when to stop eating and drinking, which morning medications to take with a sip of water, and how to wash before surgery. Confirm your arrival time and your ride, since you cannot drive yourself home after anesthesia. Pack light: a photo ID, your medication list, a case for glasses or hearing aids, and loose, comfortable clothing. A fuller day-of walkthrough is covered separately.

Your pre-op visit is the time to close any gaps. Good questions include what specifically will be done and why, what the expected recovery looks like week by week, which activities are restricted and for how long, and who to call with concerns after you go home. Writing your questions down beforehand — and bringing someone with you — makes the visit far more useful.