Our LocationsPleasant Hill
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Patient ResourcesAbout Your VisitWhat should you bring to your appointment with Dr. Jason Smith We want to make your visit as beneficial for you as possible. Please prepare for this by bringing:
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Pre-op InstructionsPreparation for Surgery:
Do not eat or drink (including water) after midnight or 8hrs prior to admission. You may brush your teeth, but do not drink water. Do not take aspirin or non-steroidal anti-inflammatories (Advil, Motrin, etc) for seven days prior to surgery. Appetite depressants such as Redux, Pondimin should be discontinued 14 days prior to surgery. If you take Coumadin, please inform Dr. Smith. If you are in doubt about any medication, PLEASE ASK. Day of Surgery:
Additional specific information will be given at your pre-op appointment with our office. Post-op InstructionsDr. Smith will give you specific instructions regarding your recovery. Pain medications will be provided at the time of discharge from the hospital or surgery center, and instructions for neck or back brace wear will be provided. You will need to arrange for a follow-up appointment 7-10 days after you go home from the hospital or surgery center. Constipation is a common side effect of pain medications. Over the counter stool softeners usually will resolve this problem. Most incisions should be kept covered and dry for at least 5 days after the surgery. Under no circumstances should a patient soak in a bathtub, hot tub, or get into a swimming pool until given clearance by Dr. Smith. (For educational videos regarding the actual surgical details of these procedures please click the blue icon at the bottom left of this page.) Anterior Cervical Disc Replacement/ Anterior Cervical Discectomy and Fusion
Collars/Braces--For fusions, two collars are provided--one for wear most of the time, and the second to be worn during showers. For one level disc fusions, the collar should be worn most of the time for the first month. For two or three level disc fusions, the collar should be worn full time for two to three months. Upon removal of the collar after this period of collar wear, your neck will be stiff. For most patients, this stiffness will resolve over the first month of living out of the collar. Medications--Pain will diminish rapidly for most patients, allowing narcotic pills to be tapered rapidly. Anti-inflammatory medications such as ibuprofen(advil), naproxen (aleve), Relafen, oxaprozin, Daypro, etc, should not be used during the first two months after a fusion operation because these medicines can slow down the process of fusion. Occasionally, Dr. Smith will allow the use of Celebrex for a few days. Use of these medications is permitted after disc replacement. Posterior Cervical Laminoforaminotomy/ Laminoplasty These surgeries, done on the back of the neck, for neck and arm symptoms, usually require a one to four day hospitalization, depending on the extent of surgery. Neck pain is increased for several days after surgery, and pain radiating out to the shoulders over the trapezius muscles is common for a few days. You will wear a soft collar for comfort, that may be gradually tapered as pain allows. Medications--Pain will diminish rapidly for most patients, allowing narcotic pills to be tapered rapidly. Anti-inflammatory medications such as ibuprofen(advil), naproxen (aleve), Relafen, oxaprozin, Daypro, etc, may be used in conjunction with and to gradually replace narcotics. Dr. Smith will give you specific instructions on their use. Posterior Scoliosis/Kyphosis Surgery
Medications--Pain will diminish rapidly for most patients, allowing narcotic pills to be tapered rapidly. Anti-inflammatory medications such as ibuprofen(advil), naproxen (aleve), Relafen, oxaprozin, Daypro, etc, should not be used during the first two months after a fusion operation because these medicines can slow down the process of fusion. Occasionally, Dr. Smith will allow the use of Celebrex for a few days. Constipation is a common side effect of pain medications. Over the counter stool softeners usually will resolve this problem. Anterior Thoracoscopic Scoliosis Surgery This surgery is done through the chest wall, usually with a patient lying on his or her side during the surgery. Occasionally, larger open incisions are required in order to place the screws and rods necessary to affect correction of curves. A chest tube will be left in place a few days after surgery, allowing blood and other fluid to drain out of the chest cavity. Neuromonitoring involves the placement of electric leads into the arms and legs (through tiny needles placed after the patient is asleep) that allow constant surveillance of the function of the spinal cord. Most patients are asked to donate one or two units of their own blood several weeks before surgery to be used during surgery and afterward. Surprisingly, even after such extensive surgery, most patients are able to stand and walk a few steps the day after surgery with physical therapy. Over a few days physical therapy will allow walking several hundred feet, climbing stairs, and basic grooming. Most patients will need some help showering for a couple of weeks after they get home. Some patients may be required to wear a brace for 3 months or so after surgery. Thoracoscopic Discectomy This surgery is done through the chest wall to allow removal of disc herniations into the spinal canal within the thoracic spine. Fusion of the disc space is sometimes required as well. A chest tube will be left in place a few days after surgery, allowing blood and other fluid to drain out of the chest cavity. Neuromonitoring involves the placement of electric leads into the arms and legs (through tiny needles placed after the patient is asleep) that allow constant surveillance of the function of the spinal cord. Lumbar Microdiscectomy/microdecompression These surgeries are minimally invasive, done through a small incision on the lower back to take pressure of compressed nerves. A microscope is used to magnify the anatomy, allowing smaller incisions and more precise work around the nerves. The surgeries are often done in an outpatient surgery center, with the patient going home 6-23 hours after the surgery. More extensive surgeries such as multi-level decompressions are usually done in the hospital setting, and result in a one to three day hospitalization. Patients usually are able to walk shortly after surgery. Incisions should be covered with a dressing for three to four days. Following this, dressings can be removed and showering is allowed. Anterior Lumbar Interbody Fusion/ Lumbar Disc Replacement
Medications--Pain will diminish rapidly for most patients, allowing narcotic pills to be tapered rapidly. Anti-inflammatory medications such as ibuprofen(advil), naproxen (Aleve), Relafen, oxaprozin (Daypro), etc, should not be used during the first two months after a fusion operation because these medicines can slow down the process of fusion. Occasionally, Dr. Smith will allow the use of Celebrex for a few days. Use of these medications is permitted after disc replacement. Posterior Lumbar Fusion This surgery is typically done for back and leg pain. It is performed through an incision on the low back, and, similar to low back decompression, the erector muscles that lie along the spine must be moved away from the spine to gain access to the spine. A laminectomy is typically performed, and screws are placed into the vertebra. This process results in fairly significant pain that lasts a couple of days, then begins to improve. Immediately after surgery the patient will be given a PCA--patient controlled analgesia-- through which the patient will be able to give him or herself pain medicines. The day after surgery mobilization with physical therapy begins. This process continues until several days later independence in arising from the bed, going to the toilet, and basic grooming are possible. Patients are able to climb stairs before they are discharged from the hospital. Medications--Pain will diminish steadily for most patients, allowing narcotic pills to be tapered gradually. Anti-inflammatory medications such as ibuprofen(advil), naproxen (Aleve), Relafen, oxaprozin (Daypro), etc, should not be used during the first two months after a fusion operation because these medicines can slow down the process of fusion. Occasionally, Dr. Smith will allow the use of Celebrex for a few days. |
These surgeries, done on the front of the neck for neck or arm symptoms, usually require one or two day hospitalization. After surgery, swallowing may be painful, and sometimes it may be difficult to swallow pills and larger bites of food. These symptoms usually resolve within days or weeks. Cepacol lozenges can help with painful swallowing. Hoarseness occasionally appears after these surgeries, and also typically resolves within days or weeks. Pain between the shoulder blades is common after these surgeries, and will typically resolve over two to three weeks. It is not uncommon to have some lingering arm symptoms such as tingling or numbness for a short period of time after surgery from inflammation at the area of surgery. For most patients, these symptoms will clear up fairly quickly. If bone graft was harvested from the hip bone (ilium), this area will be mildly sore for a few days. Dr. Smith utilizes a small incision (usually less than 1 inch) to harvest bone, and therefore the pain at this area is typically very mild. You will stand up and walk the day after surgery. 
This surgery is typically done from the upper thoracic spine to the lumbar spine from the back. Correction of spinal curves involves placing screws and rods made of titanium. These surgeries usually take several hours, and Dr. Smith almost always utilizes neuromonitoring. Neuromonitoring involves the placement of electric leads into the arms and legs (through tiny needles placed after the patient is asleep) that allow constant surveillance of the function of the spinal cord. Most patients are asked to donate one or two units of their own blood several weeks before surgery to be used during surgery and afterward. Surprisingly, even after such extensive surgery, most patients are able to stand and walk a few steps the day after surgery with physical therapy. Over a few days physical therapy will allow walking several hundred feet, climbing stairs, and basic grooming. Most patients will need some help showering for a couple of weeks after they get home. Some patients may be required to wear a brace for 3 months or so after surgery. 
These surgeries are done through the abdomen to access the front of the lumbar spine. They are done to resolve back pain and leg pain. The incision may be just to the left of the belly button vertically, below the belly button transversely, or possibly on the flank, under the ribs. A general, vascular, or cardiovascular surgeon will assist Dr. Smith in gaining access to the spine, and will assist in the procedure. For spine fusion procedures designed to remove a diseased disc and fuse across a disc space, most patients will be required to wear a brace for two to four months. For disc replacement patients, brace wear will be shorter, or will not be necessary at all. The day after surgery physical therapist will help you stand and take several steps. This will continue over several days until you can easily arise from bed move to the bathroom, walk hundreds of feet, and climb stairs. Doing surgery through the abdomen often leads to slowing down of normal bowel function. Passing gas frequently ceases for a couple of days. You will not be able to eat or drink much until your bowels wake up enough to allow passage of gas. Bloating, which is the end result of this condition (ileus), condition until gas is passed, and often until a normal bowel movement has occurred.