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Spine care

Many people live with spine issues or back pain. Spine conditions are complex and can affect every aspect of your life. Spine Care at United Hospital offers comprehensive, coordinated spine care services. Our experts will manage your care in a conservative manner, using evidence-based guidelines.

At United Hospital, doctors and nurses with special training in the treatment and management of spine conditions collaborate with other dedicated professionals to ensure you have the most positive outcome possible. These partners include:

  • pain management specialists from United Pain Center
  • neurophysiology physicians and staff to monitor spinal cord function during spine surgery
  • nurses trained to provide specialized spine care from the operating room to inpatient
  • orthotists who have expertise in fitting patients with braces that are individualized to the patient and their type of spine surgery
  • dedicated physical therapists from Courage Kenny Rehabilitation Institute
  • United Hospital medical imaging
  • occupational therapists
  • social workers and case managers who provide resources to continue rehabilitation
  • speech pathologists

Our partners in care

Working together with these partners, we provide comprehensive care for spine patients:

Learn more

Spine Pre-Op Classes

If you are a patient scheduled for spine surgery at United Hospital and are unable to attend the pre-operative class offered at either of these locations in person, your healthcare team requests that you please watch this series of spine preoperative videos.

Please allow about 25 minutes to view the video series.

The videos will provide education on:

  • How to get ready for surgery
  • What to expect during your hospital stay
  • Pain management
  • Activity after spine surgery
  • After hospital care for spine surgery

To confirm you have completed watching the videos, please send an email with your name and the month your surgery is scheduled for to:jtedunited@allina.com

Please note that this email address is ONLY for confirming that you've watched the videos. If you have questions, please contact your clinic. We can't answer individual patient medical questions via this email.

Hello, and welcome to the Allina Health Spine Program Pre-surgery Education Class. My name is Katie, and I am a registered nurse with Allina Health. I've specialized in caring for patients after spine surgery for over 12 years. In addition to caring for patients after spine surgery, I have taught a spine pre-surgery education class at one of our Allina Health hospitals. It is recommended that you watch all of the spine pre-surgery education videos one to two weeks before your surgery. 

If your surgery is scheduled within less time, please watch the videos as soon as possible. If you think of questions during these videos, please write them down and call the number provided to you in your paperwork or contact your surgeon's office. As you watch these videos, you will get information about how to prepare for surgery, what to expect the day of your surgery and during your hospital stay, pain management, activity after spine surgery, and making plans for leaving the hospital and your follow up care. We will begin with discussing how to prepare for your surgery. Please complete the following checklist before your surgery. 

Be sure to review all information given to you from your surgeon one to two weeks before your surgery. The information given to you may include a patient education book, care map, pre-surgery instructions, and other materials to help you prepare for your surgery. Schedule and keep all of your appointments to make sure your surgery can take place as scheduled. Discuss all medicines you are taking with your health care provider. Be sure to discuss any prescription and over-the-counter medicines, including herbals or vitamins you are taking. It is important for you to know whether you need to stop taking a medicine before surgery and which medicines are safe for you to continue taking. 

Call your insurance company to find what is and isn't covered under your plan. You can fill out the worksheet in your patient education book to help you. You are encouraged to select a loved one or close friend to be your personal support coach. The recommended qualities in a coach are to be a caring and compassionate cheerleader, offer you comfort and support during your recovery, be available to actively participate and help with your rehabilitation, communicate with you and your health care team, help listen and encourage your return to normal activity. Your coach's responsibilities include reviewing the pre-surgery education and videos with you, being available during your hospital stay, helping you in your recovery when you leave the hospital. 

In the one to two weeks before your surgery, please review all pre-surgery instructions. Be sure to fill out and mail in any forms or paperwork that you have been asked to complete before your surgery. If you haven't already done so, please begin the strengthening program in your patient education book. Walking before surgery is also important and can help you to have a successful recovery. Talk with your primary care provider or surgeon about starting your exercise program. It is recommended that you practice the body mechanics or posture and movements you will be using after your spine surgery. You will move a little differently after your surgery as your spine heals. 

Practicing these body mechanics before surgery will help you be more successful using them after your surgery. Please watch part four, Activity After Spine Surgery, for more information about your body mechanics and your activity after surgery. Arrange for help with household tasks, including child and pet care if needed. You may also need help with laundry, grocery shopping, house cleaning, and yard work or snow removal. It is important to prepare your home for your needs after surgery to have a safe and successful recovery. Review the checklist in your patient education book for more information. 

Move items you use a lot to tabletop height surfaces or to middle shelves. Remove clutter and rearrange furniture to create clear walking paths in your home. This can help to prevent falling or tripping. Pick out a chair to use during your recovery. A good chair is supportive and firm with arms. Avoid overstuffed chairs or sofas. Check and secure all stair railings. It is best if all stairs have railings. Make sure your bathroom is safe. Consider installing grab bars and applying adhesive slip strips or a bath mat to the tub or shower floor. 

If you use any tobacco products such as cigarettes, cigars, pipes, or chewing tobacco, it is recommended that you quit before your surgery. Tobacco use after surgery may interfere with the healing of your spine. Ask for support from your family, friends, and health care team to help you quit using tobacco products before your surgery. For more information about Allina Health's Smoking Cessation programs, visit allinahealth.org/classes or to attend a class call 1-866-904-9962. Please keep in mind that your surgery will be canceled if chewing tobacco is used the morning of surgery. 

Now, we will talk about what to bring for your hospital stay. Bring your patient education book and care map to the hospital. You will use these during your stay. Have your insurance cards and photo identification with you when you check in for surgery. If you have a health care directive, have a copy of it with you when you check in for surgery. Bring a list of the medicines you take. Be sure to include any prescription and over-the-counter medicines including herbals or vitamins. Do not bring your medicines with you. For your safety, medicines will be provided for you during your hospital stay. 

If you use a CPAP machine, bring it with you when you check in for surgery. If you are staying overnight in the hospital, pack a separate overnight bag with one or two sets of loose fitting, comfortable clothes and a pair of comfortable, supportive shoes to wear after surgery. Please have a family member or friend bring your belongings to the hospital after your surgery is done and you have been assigned a room number. Leave any valuables at home. You will be responsible for anything you bring to the hospital. 

Before surgery, it is important to call your surgeon's office if you have any changes in your health, especially to your teeth or skin. A tooth infection or abscess, skin infection, rash, open sore, or cut put you at risk for an infection and needs to be addressed before your surgery. Remove nail polish and artificial fingernails before surgery. Your oxygen level will be monitored through your finger nail beds during your surgery. Remove all jewelry before coming to the hospital. Please do not bring jewelry to the hospital with you. Cleanse your skin as directed. 

Thank you for watching part one-- How to Prepare For Surgery. For information about what to expect the day of surgery and during your hospital stay, please watch part two.

Part 2 will focus on what to expect on the day of surgery and what to expect during your hospital stay. Follow the instructions given to you for food and liquid restrictions the morning of surgery. If you do not follow these restrictions, your surgery may be delayed or even canceled.

Take medicines as directed by your health care provider. If you have questions about which medicines to take the morning of your surgery contact your health care provider before the day of surgery.

It is a good idea to look at your hospital map to know where to check in and where to park on the day of surgery. Remember to allow extra time for parking, walking, bad weather, and traffic. It is very important that you check in at your scheduled hospital arrival time. This should be listed on the paperwork you received from your surgeon's office. If you did not receive a scheduled hospital arrival time, please contact your surgeon's office.

When you arrive at the hospital, go to the surgery registration area or other area as directed to check in. After checking in you will be directed to a waiting room and then brought back to the pre-surgery care area. Once in the pre-surgery care area, a nurse will meet with you to complete your care plan.

After you are settled, the person with you will be invited to join you. Your health care team includes your nurse, surgeon, and anesthesiologist. They will discuss what to expect before and after surgery, your procedure, and the type of anesthesia that will be used during your surgery. This is also a good time to ask any last minute questions you may have. You will be asked to sign a consent form.

While you are in surgery and recovery, your visitors can wait in the surgery waiting room. The amount of time you spend in surgery will depend on the type of surgery you are having. Your surgeon will talk with your visitors when your surgery is over.

After surgery, you will be taken to the recovery room or Post Anesthesia Care Unit, also called the PACU. Most patients stay about 1 to 3 hours in the recovery room where your PACU nurse will monitor you as you wake up from surgery. Your visitors are not allowed in the recovery room. They can wait for you in the surgery waiting room.

When you are fully awake and your medical status is stable, you will be taken to the post surgery care area where nurses specialized in spine care will care for you. A member of the hospital staff will tell your visitors your room number so they can meet you there. This is a good time for visitors to go back to the car, collect your belongings, and bring them to your room.

Having no pain while in the hospital is not realistic but pain can be controlled. Your health care team will work closely with you to help manage your pain during your hospital stay and when you return home. Watch Part 3 of the spine program pre-surgery education videos for information about how to manage your pain after surgery.

It is also important that you review your care map. This will help you understand what to expect during your hospital stay and your goals after surgery. If you did not receive a care map please contact your surgeon's office to ask for one. You can also ask for one at the hospital. The following information in this video will focus on your care map goals. It is a good idea to follow along with your care map, if you have one.

Activity after spine surgery is very important for your recovery and to help prevent complications. On the day of your surgery, you will work with your health care team to sit at the edge of the bed. If you are able, you may also stand or walk. Your goal is to walk three to five times each day during your hospital stay. Your health care team will help you to walk safely and meet this goal. You will also be asked to do ankle pumps, buttocks and thigh squeezes, as well as other activities if ordered by your surgeon while in the hospital. These exercises, along with walking, help to promote circulation and to build strength after surgery.

Please watch Part 4, Activity After Spine Surgery, for more information about your activity restrictions after surgery and your home exercise and walking program. After surgery, your surgeon may order for Occupational Therapy, OT, and Physical Therapy, PT, to work with you during your hospital stay. OT and PT help to make sure you are managing your daily activities safely. Such as, walking, climbing stairs, getting in and out of a car, dressing and managing your bathroom needs.

The next section on your care map focuses on food and liquids after surgery. Many patients may have sips of clear liquids right after surgery. Your nurse will let you know what your surgeon has ordered for you to eat or drink after surgery. What you can eat or drink will be advanced as tolerated. This means that once your stomach and bowels are ready, you will be able to drink more liquids and eventually eat your regular foods.

Your nurse will listen to your stomach for noises and ask if you are passing gas to determine when your stomach is ready. Having enough fluids in your body after surgery is very important for your healing. You will have an intravenous line, or IV, to give your body the fluids it needs during and right after surgery.

Once you can drink liquids, your IV will be stopped. Your health care team will encourage you to drink six to eight glasses of liquid each day. Your care team will also help to make sure your bladder and bowels are working properly after surgery.

You may have a bladder catheter placed during surgery to monitor your urinary output. The bladder catheter is usually removed within one to two days. Removing the bladder catheter as soon as possible will help prevent a urinary tract infection or UTI.

After the bladder catheter is removed, your health care team will monitor your ability to urinate by measuring your urine output. You may also have a bladder scan to make sure you have fully emptied your bladder.

It is very important to prevent constipation after surgery. Constipation can be caused by pain medicines or decreased activity after surgery. Walking is one of the best ways to prevent constipation. You will begin walking as soon as you are able after surgery and continue to walk three to five times a day during your recovery. Make sure you drink plenty of liquids and eat high fiber foods.

The next section of your care map focuses on your breathing. You may need to use oxygen for one to two days after your surgery. You will be taken off the oxygen before you leave the hospital. If you use a CPAP machine, remember to bring it with you to use during your hospital stay.

Preventing pneumonia after surgery is very important. You will be asked to walk around and sit in a chair several times a day. This activity will encourage you to take deep breaths. You will also be reminded to do deep breathing exercises. To help with these exercises, your surgeon may order for you to use an incentive spirometer. Your health care team will teach you how to use the incentive spirometer, if needed.

It is important to take care of your incision after surgery. You will have a dressing or bandage covering your incision after surgery. Your dressing may be changed or removed during your hospital stay.

Your surgeon may place a drain next to your incision during surgery. A drain helps to draw out extra blood and fluid from the area around your incision. If you have a drain, it is usually removed one to two days after surgery.

Before you leave the hospital, you will be given instructions on caring for your incision. Do not soak your incision in water, such as a bathtub, hot tub, pool or lake. Your health care team will also give you instructions on how to shower.

Handwashing is very important to help prevent infection. Make sure to wash your hands well with warm water and soap. Ask your family and friends to also wash their hands well before helping you during your recovery.

Thank you for watching Part 2 What To Expect the Day of Surgery and During Your Hospital Stay. The comfort and discharge planning sections of your care map will be covered in Part 3 and Part 5 of the spine program pre-surgery education videos. For more information about your comforts and pain management after surgery, please watch Part 3.

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Your pain management is very important to your health care team. Part 3 will focus on your pain management and comfort after surgery. The following short videos are part of Allina Health's Pain Management Series, and will provide you with information about pain expectations during your hospital stay, how to rate your pain, treatment options for pain management, and pain management after you leave the hospital.

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Pain is often feared, because pain hurts. But pain is sometimes misunderstood. Pain is your body's natural response to injury, illness, or surgery. When you are injured or sick, you can expect to have some level of pain.

There are different types of pain. Pain that begins suddenly is called acute pain. Sometimes pain is constant. Other times, it lasts only a short while. Pain that lasts a long time is called chronic pain.

Even if pain is expected, it does not have to be severe. Having no pain while in the hospital is not realistic. But your health care team will work closely with you to help manage your pain.

Also, pain does not just mean physical pain. Anxiety or emotional discomfort is also a form of pain. Whatever kind of pain you may have, your health care team will help you manage your pain during your hospital stay, and prepare you for your return home.

Before coming to the hospital, it is very important to take your prescription pain medicine as directed with just a sip of water. It is important to do this even if you have instructions not to eat or drink anything. When you get to the hospital, tell your health care team which pain medicine you have taken. It is a good idea to bring a list of all the medicine you are currently taking.

After your surgery or procedure, you may feel new pain, such as pain near your surgical area. You and your health care team will establish a pain goal, the amount of acceptable pain you can tolerate during your hospital stay. Pain you can tolerate does not mean pain you can barely stand. Acceptable pain at a tolerable level is what it allows you to do daily activities, like walking, bathing, sitting up to eat meals, or comfortably resting in a chair.

If you have experienced pain in the past, tell your health care team what type of pain control worked best, such as heat or cold therapy, or certain kinds of pain medicine. Also be sure to mention if any medicine has caused you any problems. Above all, if your pain gets worse during your hospital stay, or if your pain medicine is not helping, please tell your health care team.

Our goal is to help you manage your pain. Your pain may not completely go away. But you can rely on your health care team working to decrease your pain and help you get well.

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Everybody feels pain differently, but it is important for your health care team to understand how you are feeling. During your hospital stay, you will often be asked to rate your level of pain. Different hospitals and clinics use different ways to get this rating.

Some pain scales are numbered 0 through 10, where patients choose numbers that best describe their pain. At Allina, you might be asked to rate your pain using numbers, faces, or words. The goal remains the same, to help you communicate the level of pain you are feeling and to measure your progress.

There is no correct number or description. You may think moderate pain is a 3, while others may call it a 5. The important thing is to be consistent in how you rate your pain. This will help your health care team understand how you are feeling.

For example, if today your pain is a 3, but tomorrow, it is a 4, this tells your health care team to make important changes to your medicine. You will be asked to rate all your pain, not just pain from your surgery or procedure. For instance, if you feel pain from an old injury, be sure to tell your health care team.

You will also be asked to describe your pain. What does your pain feel like? Is it sharp and stabbing? Or is it dull and throbbing?

Is it a burning pain? Is your pain constant, or does it come and go? Please do your best to describe your pain.

Remember, this is your pain. Be honest about how you feel. Your comfort is important to us. You and your health care team will work together to manage your pain with different treatment options.

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Identifying and describing your pain is the first step toward healing. The next step involves treatment options for pain control designed to help keep you comfortable as you recover. Your health care team will review your pain medicine with you. Be sure to tell them about any medicine you are currently taking, including prescription, over-the-counter, and any supplements. It is also important to mention any allergies you have, as well as side effects or other problems you have had in the past from certain types of medicine.

Together, you and your health care team will decide which pain medicine is best for you. Your pain medicine may be given to you on a regular schedule, or you may be able to ask for pain medicine as needed. Pain medicine takes time to work, so it is important to take your medicine early on when you first feel pain. Do not wait until your pain gets worse before taking your medicine. Tell your health care team if you feel any new pain, if your pain is getting worse, or if your medicine does not seem to be helping.

Your pain medicine may come in tablets or pills, or it may be injected into your IV. Other types of pain control may include the use of nerve block, which uses medicine to shield pain from certain parts of your body. You and your health care team will decide which pain control is best for you.

As with any medicine, there are possible side effects, which occur usually within a few hours. Common side effects include constipation, dizziness, upset stomach, itching, and rashes. Side effects can be managed.

Along with your pain medicine, you may receive physical therapy to help you heal and become more active. Pain medicine may also involve heat and cold therapy. Integrative health may include massage, relaxation techniques, aroma therapy, and others. Patients have responded very well to these therapies, often healing more quickly. Your health care team will work closely with you to develop the best pain control plan possible.

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Before you leave the hospital, be sure to ask any questions you may have. Your health care team will be happy to help you. Managing your pain continues when you return home from the hospital.

Be sure to follow all instructions you were given when you left the hospital. It is recommended that you reread your instructions a day after you return home. Because you will be more active at home than you were in the hospital, your pain may increase. Should you feel new pain, or your pain becomes out of control, refer to your home instructions for whom to call.

As in the hospital, you may have side effects from your medicine. It is best to take your medicine with soda crackers or light food to help avoid an upset stomach. It is recommended that you take a stool softener and a stimulant laxative to prevent constipation.

Your pharmacist can answer any questions you may have. Follow any instructions about physical activity, including positioning techniques. This will help you heal more comfortably.

Some medicines may cause you to feel dizzy or drowsy. Be sure to know what these side effects are to help keep you safe in your home. Ask your caregiver for help. While you are taking prescription pain medicine, follow your doctor's instructions about taking any additional over-the-counter pain medicine. If you need a refill of your pain medicine, call the doctor referred to in your home instructions 48 hours before you run out of medicine.

Your safety at home is very important to us. Before returning home from the hospital, have your caregiver remove all throw rugs and arrange furniture to make a clear walking path. This will prevent tripping or falling. Also be sure to follow your doctor's instructions regarding any assist devices given to you, such as crutches, a walker, a sling, boot, immobilizers, or a cane.

Read and follow your hospital discharge instructions to answer any questions you may have. You will be given information on whom to call if you have any additional questions or concerns. Your relief from pain is very important to us at Allina Health. Thank you for allowing us to partner with you as you heal and begin your recovery.

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Thank you for watching Allina Health Pain Management Videos. It is a good idea to review your patient education book and care map for more information about your pain management and comfort after surgery. If you are interested in integrative therapies, such as acupuncture, relaxation techniques, or massage therapy after surgery, ask your health care team whether these services are offered at your hospital. Thank you for watching part 3, Pain Management. For information about your activity after surgery, please watch part 4.

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Activity is very important for your recovery, and to help prevent problems after surgery. Part 4 will focus on your activity restrictions, how to safely manage your daily activities, and your home exercise and walking programs after surgery. Follow all activity restrictions given to by your surgeon. It is recommended that you practice these before your surgery.

After your surgery, you will be instructed to avoid the BLTs. Avoid bending, including forward, backward, and side bending. Avoid lifting more than 5 pounds. Keep in mind a half gallon of milk weighs about 4 and 1/2 pounds.

Avoid twisting of your spine. Keep your nose and toes facing the same direction. You will also be instructed to limit pushing, pulling, bending, or squatting after your surgery.

You will be encouraged to limit sitting to 45 to 60 minutes at a time. Your surgeon will tell you how long you will need to follow your activity restrictions after your surgery. Now that we have reviewed the activity restrictions you will have after spine surgery, let's focus on how to manage your daily activities. The following short videos will provide demonstrations about how to safely do some common activities of daily living, such as how to move in bed, how to get in and out of bed, a chair, and a car, and how to get dressed after surgery.

To move in bed, lie on your back. If rolling to the right, bend your left knee or both knees, and put your left arm across your chest. Roll all in one movement to your right.

Reverse this for rolling to the left. Be sure to always move as one unit. Your nose and toes should face the same direction.

To get out of bed, lie on your back. Do a log roll toward your side. Swing your legs over the edge as you push your upper body up with your arms.

Keep your hips forward and your legs aligned with your upper body. Move forward until both feet are on the floor. Stand up slowly, pushing off with your hands on the edge of the bed. Be sure to keep your head up when going from a sit to stand to avoid bending forward.

To get in bed, back up to the bed until the back of your legs touch the bed. Lower yourself slowly to a sitting position on the side of your bed. Lie down sideways onto your elbow, bend your knees and raise your legs while lowering your head at the same time. Use your arms to help lower yourself without twisting your back. Once in bed, use the log roll to get comfortable if needed.

To sit down in a chair, back up to the chair until you feel it against the back of your legs. Reach back with both hands. Grip the arms of the chair and slowly sit down. Scoot your buttocks to the back of the chair.

To get out of a chair, carefully slide forward or walk your hips to the edge of the seat. Keep both feet on the floor. Put both hands on the armrests and push up with your legs to a standing position. Make sure to keep your head up when going from a sit to stand to avoid bending forward.

To get in the car, put the seat back all the way. Back up to the car seat. Reach for the back of the seat with one hand and the dashboard or something stable with the other.

Slowly bend your knees and lower yourself onto the edge of the car seat. Bend at your hips, not your back, as you slide back on the seat. A plastic bag or sheet placed on the seat may make it easier for sliding.

When you are far enough back, bend your knees and pivot on your buttocks to bring in your legs. Avoid twisting your body. Do not grab the door or overhead handle on the door frame for support.

To get out of the car, rotate your buttocks until your feet are resting on the ground. Avoid twisting your body. Place one hand on the back of the seat and the other on the dashboard. Scoot your hips to the edge of the seat and stand up using your legs.

For your safety, sit on the edge of your bed or in a chair when you get dressed and undressed. To put on underwear and pants, cross your right leg over your left knee and pull your clothes on. Repeat this step with your left leg.

Once your clothes are about knee height, stand up to finish getting dressed. To put on socks and shoes, sit back down on the edge of your bed or in a chair. Reverse these steps to take your clothes off. If you are unable to cross one or both of your legs over your opposite knee, there is equipment that can be used to help you dress and undress your lower body. Talk with your health care team for more information about the equipment available, or review the information in your patient education book.

It is important that you do your home exercise program after surgery. Exercise can help prevent complications, promote circulation, and improve healing and muscle tone. Your exercise program will be to do ankle pumps and buttocks and thigh squeezes. Talk with your surgeon before you begin any other exercises.

In addition to your home exercise program, it is important that you walk every day. Walking after surgery can help keep your spine healthy and strong and build endurance and strength. Try to walk three to five times around your home each day.

Trips to the kitchen and bathroom are not enough. Build up to walking outside and around your community. For your safety, avoid uneven ground, hills, and slippery surfaces.

Your patient education book has more information about how to start a walking program after surgery. Thank you for watching part 4, Activity After Spine Surgery. For information about making plans for leaving the hospital and your follow-up care, please watch part 5.

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It is important to make plans for leaving the hospital or discharge before your surgery. Make sure to talk with your family and friends about your plans for leaving the hospital before your surgery. Arrange for someone to drive you home from the hospital.

You will not be able to drive yourself. You will also need to arrange for help with household tasks. You can find more information in part one, "How to Prepare for Surgery." If you do not have help at home or have other medical conditions which could affect your ability to go home safely after leaving the hospital, talk with your health care team about other options, such as home health care or a short-term rehab facility.

Your care map will tell you your expected day to leave the hospital. You will need to be in stable condition and meet your goals before you can leave the hospital. You may be able to leave the hospital sooner than your expected date if you are recovering well and meet your goals.

Plan for someone to pick you up around 11:00 AM the day you leave the hospital. You will not be able to drive yourself. Before you leave the hospital, your nurse will review your instructions for how to take care of yourself at home.

It is helpful to have a family member or friend listen to the instructions with you-- that way, they can help you at home if needed. Please ask whomever will be picking you up to be at the hospital at least 30 to 60 minutes early to allow enough time for your nurse to review the instructions with you before leaving the hospital.

Make sure you ask questions if you have any concerns or do not understand your home instructions. Review your instructions with a family member or friend once you return home from the hospital. Follow all instructions given to you. Call your surgeon's office if you have questions or concerns about any of the instructions.

Review part three for more information about how to manage your pain after leaving the hospital.

Thank you for watching the Allina Health Spine Program, Pre-Surgery education videos. If you have questions or concerns about this information, please call the number provided to in your paperwork, or contact your surgeon's office.

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