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Back Surgery: What to Expect

Having spine surgery can be a stressful and emotional time for anyone, but Dr. Kushwaha and the rest of his staff are invested in using a team approach to provide you with the best possible experience.

The Weeks and Days Before Your Surgery 

When scheduling your procedure with your surgeon, make sure you obtain an estimate of how long you will be in the hospital. Depending on the type of spine surgery, you may be admitted for a number of days. Make sure to plan accordingly, considering work schedules, holidays, and upcoming family plans.
You will be referred by your surgeon to an internal medicine specialist for a medical evaluation and surgical clearance. This typically includes a history and physical examination as well as laboratory tests. If your particular medical condition requires it, other tests might be needed before surgery, such as an electrocardiogram (EKG) or a chest x-ray.

You may be instructed to stop certain medications for several days/weeks before your surgery, depending on the medication. It is important for you to bring a list or a bag of pill bottles including all your medications to your medical clearance, including vitamins, over-the-counter medications, and supplements.

You may be instructed to stop certain medications for several days/weeks before your surgery, depending on the medication. It is important for you to bring a list or a bag of pill bottles including all your medications to your medical clearance, including vitamins, over-the-counter medications, and supplements. Image that explains not to take pills before surgery

Before your scheduled procedure, a nurse from will call you with additional instructions and reminders. You will be told when and where to come the next morning, and you will be reminded not to eat or drink anything after midnight.

The Morning of Surgery 

On the morning of your surgery, you will arrive several hours before your procedure is scheduled to begin. You will begin your day in a Pre-Surgical “Waiting Area”, where dedicated staff will help prepare you for surgery. You will be asked to remove all jewelry before entering the operating room. You will be asked to change into a hospital gown, and will be assigned to a private or semi-private room in the waiting area. One member of your family can be with you during this time. A nurse will start an IV to give you fluids, and if you are a woman of childbearing age, you will be asked to provide a urine specimen for a pregnancy test.

A physician’s assistant will take your history and perform a physical exam. You will be asked to confirm what type of surgery you are having and will be asked to sign consent for that surgery if you have not already done so. While in the waiting area, your surgeon will come to speak with you and sign your surgical site. This is simply a safeguard to confirm where on your body the surgery will be performed. At this time, you will also meet your anesthesiologist, who will discuss the anesthesia you will receive.


Your anesthesiologist will be a Board-Certified or Board Eligible physician who is highly specialized in caring for patients having spine surgery. Having previously reviewed your chart, laboratory results, and other studies, your anesthesiologist will already know much about you. However, he or she will have a detailed conversation with you to clarify any issues and address any concerns you, or your anesthesiologist, may have.

Image of woman undergoing anesthesia
Your anesthesiologist will also explain the type of anesthesia you will receive, including any special monitoring or necessary care, and discuss post-operative recovery and pain management. Earlier consultation with our Anesthesia Department can easily be arranged by your surgeon or at your request. Essentially all patients undergoing spine surgery at Hospital for Special Surgery will receive general anesthesia, which involves being put to sleep with medications that are given to you through your intravenous line.

The Operating and Recovery Rooms 
After your consultation with the anesthesiologist, a nurse will take you to the operating room. Once there, your anesthesiologist will measure your blood pressure and heart rate and will begin giving you sedative medication. Soon after initiation of general anesthesia, your anesthesiologist will insert a breathing tube, which is necessary and essential for your safety during surgery. In certain instances, your anesthesiologist may decide to insert the breathing tube under light sedation in order to ensure that you are breathing well and/or to minimize stress on your spine. The surgery will begin after a deep stage of anesthesia has been achieved.

Recovery in the Hospital 

After the surgery, you will wake up in the operating room or recovery room, depending on your sensitivity to the anesthesia. There will be an attending anesthesiologist, 24 hours a day, who will closely follow your recovery and post-operative care. You will also have a dedicated nurse caring for you. Several hours after surgery, as you become fully awake, your surgeon will see you and your family members will be allowed to visit. Later in the day, you will be moved to your hospital room. Depending on your medical history and the extent of the spine surgery, your anesthesiologist may have you spend the first night in recovery room where there is continual monitoring of your vital signs and you receive the direct care of the anesthesiologist and nurses.

Image of doctor holding patient's hand
There will be some level of pain following all orthopedic surgeries. The Anesthesia Department works closely with patients and uses a multidisciplinary approach to aggressively manage post operative pain. This includes a variety of different pain medications, physical therapy, and possibly epidural or spinal medications. Your surgeon will continue to check on you after the procedure and you will have multiple post op appointments to make sure the surgery was successful.

Dr. Kushwaha is a board certified Orthopedic Surgeon specializing in Spine Surgery. To learn more about his procedures or to schedule an appointment please call, (713) 587-6263.

About Vivek Kushwaha

Vivek P. Kushwaha attended the University of Texas at Austin where he earned his B.A. from the College of Natural Sciences. He then earned his medical degree from the University of Texas Medical School at San Antonio, Texas.

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