Before Surgery

Before Surgery

Prior to surgery you will have a variety of preoperative tests, either at your primary care provider’s office or at the Nebraska Spine Hospital. At this appointment you will receive special instructions about how to prepare for your procedure, and how to plan for your recovery. If your preoperative visit is at Nebraska Spine Hospital you will have the opportunity to meet with our nurse navigator who will guide you and your family through your spine surgery.

Prior to your surgery you will receive a phone call from our financial counselor to ensure that all of your details are in order and to guide you through the paperwork.

Pre-Operative Visit and Testing

Hospital Visit/Tests may include: blood tests, urine test, electrocardiogram (ECG), chest x-ray, cardiac stress test, CT scan(s) of spine.

  • Meeting with the Anesthesiologist – This is the doctor who puts you to sleep during surgery. If you have any questions regarding the medicines involved in this process, be sure to ask this physician.
  • The Anesthesiologist will let you know which of your routine medications you are able to take the morning of surgery.
  • This visit may last from 1-3 hours in length depending on the tests ordered.

Physical Examination

  • A physical will be done by a Doctor (not the Spine Surgeon) before surgery to ensure that your body can tolerate surgery.
  • Some Doctors may want to do the blood tests, etc. in their office. If these are completed in the doctor’s office, you will still visit the hospital to meet with the Anesthesiologist and get instructions for surgery.

Planning Your Visit

What About My Medications?

Before Your Hospital Admission

  • Provide a current and accurate list of medications to your Surgeon and Doctor performing you pre-surgical physical (including any over the counter meds and herbal supplements)
  • Do not take aspirin, ibuprofen, or other anti-inflammatory medication two weeks before surgery (including Advil, Motrin, Aleve) and for up 3-4 months after surgery. These medications can inhibit bone fusion.

Preparation Day Before Surgery

Skin Scrub

  • Bathe and shampoo your hair the evening before surgery.
  • Sleep on clean sheets.
  • Remove nail polish before surgery. Your Doctor may have you scrub your skin with a special soap to decrease the risk of infection.
    • The area of focus depends on the surgical procedure being performed.
    • You may need help from a family member.
    • Use small circular motions for 15 minutes the evening before and the morning of surgery.
  • If you have any sores or irritated skin areas, notify your Physician before surgery.

Diet/Routine Medications

  • If surgery is scheduled for morning, stop eating and drinking at midnight the night before (including water, coffee, gum, breath mints, etc.)
  • If surgery, is scheduled for afternoon, you may be allowed to drink fluids until the early morning.
  • An empty stomach helps decrease the risk of having an upset stomach and vomiting.
  • The Anesthesiologist will specify when to stop eating and drinking.
  • On the morning of surgery, brush your teeth and wash up. Do not swallow any water.
  • You may be instructed to take some medications on the day of surgery, take the pills with a small sip of water just enough to be able to swallow the pills.
  • Bowel Preparation – Your Doctor may order a bowel preparation solution to drink the afternoon prior to surgery.


  • All jewelry, makeup, and nail polish must be removed prior to surgery. If you have artificial nails, at least one must be removed for oxygen monitoring.
  • Any jewelry with you the morning of surgery will need to be given to family members.
  • If you have a ring that you can not get off or do not wish to remove, ask the nurses to tape it securely to your finger.
  • Please leave all valuables at home.

Preparing Your Home for a Safe Return

Before coming to the Hospital for Surgery:

  • Find a friend/loved one to help you for at least a week when you return home. If you need help finding someone, a Social Worker can assist you in making other arrangements.
  • Remove any tripping hazards such as throw rugs, extension cords, or phone cords.
  • Have a plan for your pets.
  • Make meals and freeze them.
  • Clean your house and do the laundry.
  • Make sure walkways, stairs, and hallways are well lit and free of clutter.
  • If you do not have a shower, install a handheld shower hose that attaches to the tub faucet.


Research has shown that nicotine is associated with poor surgical spine fusion outcomes, and it negatively affects the respiratory, circulatory, and digestive systems which impacts recovery after surgery.

Depending on your Surgeon, you may be required to be nicotine free.

  • This includes cigarettes, chewing tobacco, and nicotine replacement gum or patches.
  • Your Surgeon may require that you be nicotine free for at least 2 weeks prior to surgery (unless you have shown rapid neurological deterioration).
  • Once you are nicotine free for 2 weeks, the office will schedule you for a urine nicotine test.
  • If the test is negative, the Nurse will discuss a surgery date.
  • You will be re-tested for nicotine at the time of the pre-operative blood work.
  • If the test is positive, your surgery will be cancelled.