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Pre-OpLumbar Spine

Preparing for Your Lateral Lumbar Fusion

What is different about preparing for a staged lateral and posterior lumbar fusion — a long day in the operating room, being repositioned partway through, and the questions to bring to your preoperative visit.

Preparing for Your Lateral Lumbar Fusion

A staged operation — part of it from your side, part of it from your back. What is different about getting ready for this particular operation.

Cotton O'Neil Neurosurgery and Spine Center — Stormont Vail Health

Start with the general guide

Our Preparing for Your Spine Surgery handout covers everything that is the same no matter which operation you are having: stopping nicotine, getting your medical conditions optimized, the medication review and the coordinated preoperative visit, setting up help at home, the Hibiclens showers, and the morning-of routine.

Read that one first. This page only covers what is specific to a lateral lumbar fusion.

If anything here conflicts with what Dr. Tuchek, the pre-anesthesia team, or your other physicians tell you, follow their specific instructions. Those are tailored to you; this is a general roadmap.

What makes this operation different

This operation is staged. It is planned as two parts, done in sequence, under one anesthetic on one day:

  1. The first part is done from your side. You are positioned on your side, and the disc space is reached from there.
  2. The second part is done from your back. You are turned face-down, and screws and rods are placed to hold the segment.

You are asleep for all of it, including the turn. But it means two things you should know before the day: this is a long operation, and your operation involves more than one approach to your spine.

Plan for a long day

  • Dr. Tuchek's operative plan for this case schedules about seven hours of surgery — roughly three hours for the first part and four for the second. That is the planned operating time only. Anesthesia, positioning, the turn between the two parts, and the recovery room all come on top of it.
  • Tell whoever is waiting to plan for a full day, not a morning. Ask them to bring what they need to be comfortable, and make sure our office has the right phone number for updates.
  • Nerve monitoring is planned throughout both parts of the operation. That means additional staff in the room and additional leads placed on you after you are asleep. It is part of the plan, not a sign of trouble.

Ask at your preoperative visit whether your operation is planned as one day or as two separate dates, so your family plans around the right thing.

Your implants are confirmed before your date

This operation uses implants that are ordered and confirmed with the manufacturer ahead of time, and a manufacturer representative is required to be present for it.

You do not have to do anything about this — but it is worth knowing, because it is one of the reasons a spine operation's date can move. If your date changes, ask our office whether the implant plan is the reason.

The universal step that matters most here: nicotine

The general guide asks every patient to be off nicotine for at least four weeks. For a fusion that instruction is load-bearing.

Nicotine impairs bone healing and fusion, which is why we ask patients to stop before surgery.

If you smoke, vape, dip, or chew, this is the most important thing you can do for your surgery. Call our office at (785) 368-0767 for a referral to Stormont Vail's tobacco-cessation support.

Mention any history of anemia at your pre-op visit

The general guide asks you to raise a history of anemia or low iron. For a fusion that item earns its place:

Fusions involve more blood loss than decompressions, and a transfusion is occasionally needed.

Bring it up at the coordinated preoperative visit so there is time to act on it.

Ask where your incisions will be

The general guide asks you to check the skin over your surgical area at least two weeks out, and to tell us about any rash, open sore, or active infection there with enough lead time that we can address it before your date.

For this operation, ask our office exactly where your incisions are planned, because more than one approach is used and the answer is not just "my back." Then check that skin — all of it — on the general guide's schedule.

Questions to ask at your preoperative visit

This operation is planned individually. Rather than give you numbers that may not be yours, here is the short list to write down and bring:

  • How long should I expect to be in the hospital?
  • When can I drive again?
  • When can I go back to work?
  • What are my activity restrictions, and how long do they last?
  • Will I need a brace?
  • Who should be with me at home, and for how long?

Ask for the answers in writing, and check them against your discharge paperwork before you leave the hospital.

Other handouts that matter most for this operation

Ask our office for these:

  • Preparing for Your Spine Surgery — the general prep guide. Start here.
  • Anticoagulant and Antiplatelet Medications — if you take aspirin, Plavix, Brilinta, Eliquis, Xarelto, Pradaxa, Savaysa, or Coumadin.
  • GLP-1 Medications and Surgery — if you take Ozempic, Mounjaro, Wegovy, or Trulicity.
  • The Day of Your Surgery — the morning-of routine and what happens at the hospital.
  • Caregiver Preparation Guide — for whoever is helping you at home.
  • Spine Surgery Recovery — what the days and weeks afterward look like.

When to call us

Before surgery, call our office at (785) 368-0767 during clinic hours if you develop a fever, cough, or new illness; a new cut, rash, or skin infection near any planned incision; or if you realize you took a medication you were told to hold.

For medical emergencies, call 911 or go to the nearest emergency department. The clinic line is not an emergency line and is not staffed overnight.

The general guide's full "When to call us" list applies to this operation as well.

Cotton O'Neil Neurosurgery and Spine Center — Stormont Vail Health Cotton O'Neil Kanza Park · 1st Floor · 2660 SW 3rd St · Topeka, KS 66606 · (785) 368-0767 chadtuchekmd.com

This handout provides general guidance for patients of Dr. Chad Tuchek at Cotton O'Neil Neurosurgery and Spine Center, Stormont Vail Health. It is not individualized medical advice. Always follow the specific instructions you receive from your surgeon, the pre-anesthesia team, and your discharge paperwork. For medical emergencies, call 911 or go to the nearest emergency department. For non-urgent questions, call (785) 368-0767.