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Spine Surgery

In Aotearoa New Zealand, common types of spine surgery include:

Spinal fusion (joining two or more bones in the spine together)
Discectomy (removal of a damaged disc in the spine)
Artificial disc replacement (replacing a damaged disc with an artificial one)
Laminectomy (removal of a small section of bone to relieve pressure on the spine).

These surgeries all require a general anaesthetic to help keep you comfortable during your surgery.

Resource summary:

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X-ray showing just the spine and torso Anaesthesia is very safe. It allows a patient to be comfortable during their surgery. Anaesthetists are specialist doctors who are highly trained to deliver anaesthesia and help look after you before, during, and after your surgery.

Before your surgery

Before your surgery, your anaesthetist will need to know about your health and medical history. This may involve seeing them in person or via a phone call. On occasion, you may also need tests or visits to other doctors to make sure you’re in good health for surgery. These extra checks might delay your surgery but are important for your safety and the best possible outcome from your surgery.

Medications

You can continue taking most of your regular medications before your surgery. However, some medications, like blood thinners or those for diabetes, need special instructions. Someone from your healthcare team will tell you what to do with these medications before your surgery. If you’re unsure, don’t hesitate to ask them.
Do not stop taking any medication unless your doctor has told you to.

Preparing for your surgery

Before your surgery, you will need to fast (stop eating food or drink). This is usually:

No food for 6 hours before your surgery
You can keep having small amounts of clear liquids until you come into the hospital for surgery.

Your hospital or anaesthetist will give you advice on when you need to stop eating and drinking before your surgery.

During your surgery

Spine surgery is done under general anaesthesia which means you will be in a safely watched state of unconsciousness for the entire procedure. Each hospital might do things a little differently, but this is an outline of what will happen:

IV (Intravenous) line: A small tube will be placed into a vein in your arm. This is where the anaesthetist will give fluids and medications.
Oxygen: You will breathe oxygen through a mask before the anaesthetic begins.
Anaesthesia medication: The anaesthetist will give you medication through the IV to make you fall safely unconscious, it will feel like you’re falling asleep.
Breathing tube: After this, a tube will be placed in your windpipe to help you breathe during surgery.

Your anaesthetist will stay with you during your whole surgery to make sure you are safe and comfortable. You will not feel any pain because of the general anaesthetic.

In some surgeries, you might be turned onto your stomach (this is called being prone) while you’re under your anaesthetic. This can add a small risk of complications related to your anaesthetic. Your anaesthetist will discuss this with you before your surgery and will be monitoring you closely.

Extra monitoring during surgery

Sometimes you might need extra monitoring to make sure you stay safe during your surgery. This could include:

Arterial line: A small tube placed into an artery (blood vessels) to monitor your blood pressure and check your blood for important things like electrolytes (which help your body work properly).
Central line: A tube inserted into a large vein, usually in your neck, chest, or groin. This helps the doctors monitor your condition closely.
Urinary Catheter: A small tube placed into your bladder to collect and drain urine.

If any of these are needed your anaesthetist or healthcare team will discuss it with you first. Sometimes these extra lines will be put in after your anaesthetic is working or they may be inserted before you go into the operating theatre. They will be removed when you no longer need them.

After your surgery

At the end of the surgery, you will be carefully turned back onto your back and woken up. Then you will be moved to the recovery room, where nurses who are specially trained in post-surgery care will look after you as you wake up. Some patients may need to go to a special care unit (like High Dependency Unit (HDU) or Intensive Care Unit (ICU)) for extra care while they recover.

After major spine surgery, you might stay in recovery for several hours.

It’s normal to feel sleepy when you wake up from anaesthesia. You might also feel some pain, discomfort, or nausea. Your nurses will give you medication at regular intervals to help with pain relief and nausea. If you still feel uncomfortable, ask for more help.

You may also have a dry or sore throat or a headache. These usually go away within 1-2 days.

Your hospital stay

Most patients stay in the hospital for 1-3 days after spine surgery. However, some people may go home the same day, depending on the type of surgery, their health, and the support they have at home. Your anaesthetist may check on you again during your hospital stay to make sure you’re recovering well.

If you have had sedation or a general anaesthetic and are going home the same day, you must have an adult with you for 24 hours after your surgery. This is important for your safety.

For the first 24 hours, you should avoid these activities. They are unsafe until the anaesthetic has completely worn off:

Drinking alcohol
Driving
Operating heavy machinery

Possible risks

Serious problems are very rare but it's important you know about them. If you have any concerns or questions, talk to your anaesthetist. They will be happy to explain everything and help you feel comfortable with the plan for your surgery.

May include:

Bruising
Feeling tired
Sore throat
Headache
Sleep problems
Feeling tired and sleepy
Muscle pain
Nausea or vomiting

These are very rare and may include:

Severe allergic reaction
Severe bleeding
Heart attack, stroke, or seizure
Lung damage or pneumonia
Infection
Damage to the vocal cords

Frequently asked questions

When you're under general anaesthesia, your body is in a deeply relaxed state, and you won't have control over the muscles that normally keep food and liquids in your stomach. If your stomach contains anything, there's a risk that it could come back up (regurgitate) and enter your lungs. This can cause serious complications, such as an infection or difficulty breathing. Not eating for a period of time before your general anaesthetic (fasting) ensures your stomach is empty, reduces the risk of these problems happening and helps your anaesthesia team provide safe and effective care for you.

To make the safest plan for your surgery and anaesthetic your healthcare team may need to rule out an unknown pregnancy and ask you to perform a pregnancy test.

You should contact the hospital first and they may tell you to come back or may be able to organise some medication for you. You may have been prescribed medications to go home with that can help.

In the elderly confusion is not uncommon although it is not usually permanent. For the elderly a change in environment and the events associated with surgery can result in confusion. Ideally, the elderly should get back to their own homes where familiarity will help reduce any confusion.

Most anaesthesia drugs have no long-term negative effects, and almost all of the anaesthesia has left your body within 24 hours. About 15-50% of older patients undergoing general anaesthesia can develop some degree of temporary post-operative delirium. This means they may notice small changes in their attention, level of consciousness and other ways they use their brain. This usually settles within 7 days. However, a smaller group (about 1% of older patients) may notice these changes last longer and develop what is known as postoperative cognitive decline (POCD). Anaesthesia, sleep deprivation, pain, anxiety, medications, inadequate nutrition, and surgical complications are all factors that might contribute to POCD. Unless there is a serious complication there is little chance of permanent brain injury. On rare occasions, serious complications can occur. Your anaesthetist will talk to you about the level of risk for you if you decide to have surgery. Some different ways cognitive decline might be described to you during the period after surgery are: Before surgery: Neurocognitive disorder (mild or major). Within 7 days after surgery: Postoperative delirium. Within 30 days after surgery: Delayed neurocognitive recovery. Within 12 months after surgery: Postoperative neurocognitive disorder.

Not unless the procedure is under local anaesthetic. You may experience pain, nausea and small but reversible changes in memory and mental function after surgery or after anaesthesia. You should have someone with you. Try to arrange for an adult family, whānau member, or friend to stay with you. Otherwise, you are best to stay overnight in hospital.

You can read answers to more frequently asked questions on the Anaesthesia FAQs page. The Day of your planned surgery resource on this website also offers some information to help you prepare for your surgery.

This information is meant as a general guide only. It does not replace individual medical advice given by your healthcare providers. You should always ask your healthcare team If there is anything you’re unsure about. The NZSA does it utmost to keep this information up to date and content is subject to change. If you have any feedback or suggestions for future topics please get in touch.

Spine Surgery