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Sacroiliac Fusion Please understand this is a surgery and soreness from healing is normal, even for weeks after the surgery. Sacroiliac Fusion - Post Operative Instructions Incision Care : Dressing may be removed 24 hours after surgery, if no drainage. If used, surgical glue will come off within 14 days. Please call us with any changes or concerns such as: redness swelling or drainage at incision site temperature greater than 101° Bathing: You may shower 24 hours after surgery; avoid scrubbing the incision site for 72 hours. No baths or swimming until approved by the physician or physician assistant at your follow up appointment. Restrictions: For 6 weeks after surgery: No strenuous activity No lifting greater than 10lbs No bending or twisting at waistline No overhead reaching Exercise: Increase your light activity each day, such as walking, as tolerated. Driving: You may drive the day after the procedure if you feel okay to do so. Do not drive if you are taking pain medications. Diet: Eat a healthy diet to promote healing. Smoking: Avoid smoking. Smoking decreases the rate of bone and skin healing and also interferes with the effectiveness of pain medication. Follow-Up: You may experience soreness of the hips for up to 7 days due to changes in your posture post-operatively. You will have a post-operative appointment 7-10 days after surgery. If you have any questions or concerns, please contact our office at 734-547-4860.

ENDOSCOPIC DECOMPRESSION Endoscopic Decompression is a minimally invasive, out-patient procedure that will open space around pinched nerves. ​ Using X-ray guidance (fluoroscopy) a small metal tube, the size of a pencil, is inserted through the skin in to the spinal column. This serves as a passage for an endoscopic camera that allows the doctor live visualization of the spine. With this access, portions of the disc material, bone, and ligaments can then be removed alleviating any pressure or pinching of nerves. ​ You may be a candidate for decompression if your symptoms include pain, numbness, or weakness of the back and/or legs have been confirmed by an MRI or CT that show disc herniations or ligaments causing stenosis. ​ Endoscopic Decompression is a minimally invasive procedure with very little blood loss, tissue damage or scar formation. It has a recovery period that is variable depending on the extent of tissue removal that needs to be done. Expect to be sore in the back and or the legs for 1-2 weeks and then to have limitations the doctor will require of you for a month (see instructions below). This is a spine operation thus pain will occur, please plan accordingly to expect this and also have thing organized in your house to make the painful time easier for you. This is generally a safe procedure yet, as with any interventional procedure, it carries a small risk of potential complications such as bleeding, infection, spinal headache, and injury to blood vessels or nerves around the spine. ​ Please understand this is a surgery and soreness from healing is normal, even for weeks after the surgery. Endoscopic Decompression - Post Operative Instructions Incision Care: If there is a dressing, you may remove it on the morning after surgery BEFORE you shower. If surgical glue is used expect it will slowly peel off within 14 days. Please call us with any changes or concerns such as: redness swelling or drainage at incision site temperature greater than 101° Clear liquid drainage in the first 24 hours is normal ​ Bathing: You may shower the morning or afternoon after surgery; avoid scrubbing the incision site for the first 3 days. No baths or swimming until approved by the physician or physician assistant at your follow up appointment. ​ Restrictions: For 2 weeks after surgery: No strenuous activity No lifting greater than 10lbs ​ Exercise: Increase your light activity each day, such as walking, as tolerated. ​ Driving: You may drive 7 days after the procedure if you feel okay to do so. Do not drive if you are taking pain medications. ​ Diet: Eat a healthy diet to promote healing. ​ Smoking: Avoid smoking. Smoking decreases the rate of bone and skin healing and also interferes with the effectiveness of pain medication. ​ Follow-Up: You may experience soreness in your back for up to 2 weeks. You will have a post-operative appointment approximately 2 weeks after surgery. Actual Surgical Youtube Video

ENDOSCOPIC LUMBAR DISCECTOMY Endoscopic Discectomy is a minimally invasive, out-patient procedure to remove a portion of a damaged spinal disc. ​ Using X-ray guidance (fluoroscopy) and a small metal tube, the size of a pencil, is inserted through the skin in to the spinal column. This serves as a passage for an endoscopic camera that allows the doctor live visualization of the damaged disc. With this access, portions of the disc can then be removed alleviating any pressure or pinching of nerves the disc may have caused. ​ You may be a candidate for discectomy if your symptoms include pain, numbness, or weakness of the back and/or legs which have been confirmed by an MRI or CT that shows a disc or ligaments pinching your nerves. Endoscopic Discectomy is a minimally invasive procedure with very little blood loss, tissue damage or scar formation. It has a recovery period that is variable depending on the extent of tissue removal that needs to be done. Expect to be sore in the back and or the legs for 1-2 weeks and then to have limitations the doctor will require of you for a month (see instructions below). This is a disc operation thus pain will occur, please plan accordingly to expect this and also have thing organized in your house to make the painful time easier for you. ​ Discectomy is generally a safe procedure yet, as with any interventional procedure, it carries a small risk of potential complications such as bleeding, infection, spinal headache, and injury to blood vessels or nerves around the spine. ​ Please understand this is a surgery and soreness from healing is normal, even for weeks after the surgery. Endoscopic Discectomy - Post Operative Instructions Incision Care: If there is a dressing, you may remove it on the morning after surgery BEFORE you shower. If surgical glue is used expect it will slowly peel off within 14 days. Please call us with any changes or concerns such as: redness swelling or drainage at incision site temperature greater than 101° Clear liquid drainage in the first 24 hours is normal. ​ Bathing: You may shower the morning or afternoon after surgery after the dressing is removed; avoid scrubbing the incision site for the first 5 days. No baths or swimming until approved by the physician or physician assistant at your follow up appointment. ​ Restrictions: For the first week, no sitting upright more than 10 minutes per hour. To be clear, you can stand or lay down for the first 7 days. A recliner is fine to sit in, even sit upright in a recliner is fine immediately after the surgery. For 1 months after surgery: No leaning over (use a stick grabber if needed) No strenuous activity No lifting greater than 10lbs Exercise: Increase your light activity each day, such as walking, as tolerated. Driving: You may drive 14 days after the procedure if you feel okay to do so. Do not drive if you are taking pain medications. Diet: Eat a healthy diet to promote healing. Smoking: Avoid smoking. Smoking decreases the rate of bone and skin healing and also interferes with the effectiveness of pain medication. Follow-Up: Your doctor may have ordered a brace for you to wear. This is to be worn when up and walking. It is not needed when sitting, laying, nor sleeping. You will have a post-operative appointment approximately 2 weeks after surgery. ​ Actual Surgical Youtube Video

Spinal Cord Stimulators Spinal Cord Stimulation is the most technological way to achieve pain relief. It changes how you perceive pain by giving the brain feedback that decreases pain. There is a "Trial" procedure where temporary stimulator leads are inserted so you can take a few days to see if this procedure will help your pain. If it helps more than 50% of your pain and you want to have this relief permanently, the next step is surgical implantation of the "permanent" stimulator. Please see the 2 videos below. Deciding between Spine Surgery vs Spinal Cord Stimulator, Click Here! There are 4 Spinal Stimulator manufacturers available currently in the USA. We encourage you to gather as much information as you can, then discuss with our providers which one would be best for your condition and your unique needs. Here are links to each manufacturer for further information: ​ Boston Scientific Medtronic Nevro Abbott ​ Stimulator Trial Procedure Permanent Spinal Cord Stimulator Implant Surgery Spinal Stimulator Pre-op Instructions ​ No eating or drinking for 8 hours prio r to the scheduled procedure time You will be sent to “Pre Procedure Testing” with our internal medicine doctor to make sure all your body systems are healthy enough to have the procedure. The doctor will likely order testing. Spinal Stimulator Post-op Instructions ​ No bending, lifting, or twisting for 2 months, especially important is to avoid the twisting. Have a “lazy” day on the day of the procedure. You may have significant to intense pain over the battery site. Take your pain medicines as prescribed. Ice packs are important to control the pain, but have a thin cloth between the ice pack and your skin to not freeze the skin. From day 2 and thereafter, you must get up and walk 5-10 minutes at a time to avoid clots The time OFF work will vary for different people. Ask your doctor. You may shower or bath e the morning after your procedure. The bandage is just to collect any fluid or blood that may leak. Feel free to remove it once no drainage occurs. You may drive after 7 days, if you feel ok to do so. Please exercise judgment – if you are not stable, ask your doctor first and do not drive. No alcoholic beverage 24 hours after sedation, anesthesia, or while taking pain medication. No complex decision making or signing of any important papers 24 hours after sedation. Call if you experience unusual symptoms or develop a fever over 101 degrees.

vertiflex Vertiflex - Post Operative Instructions ​ Incision Care: Dressing may be removed 24 hours after surgery. If used, surgical glue will come off within 14 days. Please call us with any changes or concerns such as: redness swelling or drainage at incision site temperature greater than 101° Bathing: You may shower the day after surgery; avoid scrubbing the incision site for 72 hours. No baths or swimming until approved by the physician or physician assistant at your follow up appointment. Restrictions: For 2 weeks after surgery: No strenuous activity No lifting greater than 10lbs Exercise: Increase your light activity each day , such as walking, as tolerated. ​ Medications: The day of surgery your doctor may prescribe medications and antibiotics with instructions for use . Also if you are on chronic blood thinners, they are restarted after the surgery and your doctor will tell you the proper number of hours after which you need to restart them. Driving: You may drive the day after the procedure if you feel okay to do so. Do not drive if you are taking pain medications. Diet: Eat a healthy diet to promote healing. Smoking: Avoid smoking. Smoking decreases the rate of bone and skin healing and also interferes with the effectiveness of pain medication. Follow-Up: You may experience soreness of the hips for up to 7 days due to changes in your posture post-operatively. You will have a post-operative appointment approximately 14-16 days after surgery. If you have any questions or concerns, please contact our office at 734-547-4860.

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