Prepare for spine surgery by stopping smoking, optimizing your nutrition and any medical conditions, completing pre-operative testing, arranging help and a recovery setup at home, and confirming the financial side with your surgeon's office. As a fellowship-trained spine surgeon in the Las Vegas Valley, I have seen patients who prepared well recover noticeably faster than patients who showed up underprepared, so the work you do in the weeks before surgery matters.
This guide is a practical checklist you can use to prepare 6 to 8 weeks out, 2 to 4 weeks out, the week before, the day before, and the morning of surgery.
Six to eight weeks before surgery
Stop smoking
This is the single most important thing on the list. Smoking impairs bone healing, increases the risk of fusion failure, increases infection risk, and slows wound healing. For fusion surgery specifically, nonunion rates are significantly higher in smokers. Stop completely if you can, and at least 6 weeks before surgery if total cessation is not realistic. Nicotine replacement (patches, gum) still affects healing; the goal is to stop nicotine in all forms.
Optimize chronic medical conditions
- Diabetes: aim for A1c below 7 if possible.
- Blood pressure: controlled with current medications.
- Heart disease: if you have known cardiac disease, see your cardiologist for clearance and a medication plan around surgery.
- Sleep apnea: if you use CPAP, bring it to the hospital or surgery center.
- Weight: modest weight loss in the months before surgery improves outcomes and reduces complication rates.
Start a basic conditioning program
Walking 20 to 30 minutes a day, gentle core work as tolerated, and any specific exercises your physical therapist recommends. The stronger you go in, the smoother the recovery.
Confirm the financial side
Meet or speak with the practice's billing team to:
- Verify insurance benefits
- Get a written cost estimate
- Understand how out-of-network coverage works (if applicable)
- Set up a payment plan if you need one
Many of our patients have out-of-network PPO insurance. We work with you to navigate insurance, including the federal IDR arbitration process under the No Surprises Act, so financial concerns are not a barrier to top-tier spine care. We do this before surgery, not after.
Two to four weeks before surgery
Pre-operative testing
Depending on your age, medical history, and procedure, you may need:
- Blood work (CBC, CMP, coagulation)
- EKG
- Chest x-ray
- Pre-op anesthesia consultation
- Cardiac clearance if you have heart disease
- MRSA nasal swab in some cases
The office coordinates these so you do them once, not scattered.
Medication review
Bring a complete list of your medications and supplements to the pre-op visit. You will need to know what to stop, when. Common holds:
- Blood thinners (aspirin, Plavix, Eliquis, Xarelto, warfarin): timing varies by medication. Do not stop without specific instructions from the prescribing physician and surgeon.
- NSAIDs (ibuprofen, naproxen, Motrin, Advil, Aleve): usually held 1 to 2 weeks before for fusion patients because they can affect bone healing.
- Some supplements (fish oil, garlic, ginkgo, vitamin E) can affect bleeding and are typically held about a week before.
- GLP-1 medications for diabetes or weight loss (Ozempic, Mounjaro, Wegovy): coordinate with the anesthesiologist; many require a hold.
Plan your time off work
Match it to the procedure-specific timeline (see how long recovery takes after spine surgery) with at least a one-week buffer. Submit FMLA or short-term disability paperwork. Our office completes the medical portion.
Plan home support
- Week 1 to 2: you need a partner, family member, or friend at home, especially for the first few days.
- Help with: driving to follow-up, preparing meals, managing medications, helping with bathing if needed.
Pets and kids
Have a plan for pets that need walks and young children. You will not be able to lift or pull for several weeks.
The week before surgery
Set up the home
- Sleeping: ground floor if you live in a two-story house, or a recliner near a bathroom. Many patients sleep better in a recliner for the first 1 to 2 weeks.
- Bathroom: raised toilet seat if you have low toilets. Grab bars near the shower or tub.
- Reach: a grabber tool to avoid bending. Move frequently used items to waist height.
- Trip hazards: remove loose rugs, cords, and clutter from walkways.
Stock the kitchen
Easy meals for the first 2 weeks. Stew, soup, casseroles you can freeze ahead. Avoid foods that require a lot of standing or twisting to prepare.
Confirm the logistics
- Surgery date, time, and location
- Pre-op call from the surgery center (usually 1 to 2 days before)
- Driver to and from surgery (you cannot drive yourself home)
- Insurance cards, photo ID, advance directive paperwork
Pre-surgery shower routine
You may be asked to shower with chlorhexidine soap the night before and the morning of surgery. This reduces skin bacteria and surgical site infection risk.
The day before surgery
- Eat normally until the cutoff time given by the anesthesia team (usually nothing to eat after midnight, clear liquids allowed up to a few hours before).
- Hydrate during the day; dehydration makes IV placement and anesthesia harder.
- Last shower with the antibacterial soap if prescribed.
- Pack a bag if you are staying overnight: phone charger, glasses, CPAP, comfortable loose clothing for going home, any home medications in original bottles.
- Confirm transportation to the surgery center.
- Get good sleep. Avoid alcohol, which dehydrates and interferes with anesthesia.
The morning of surgery
- Follow the NPO (nothing by mouth) instructions exactly. A violation of NPO almost always means surgery is canceled or delayed.
- Take only the medications cleared by the anesthesia team, with a small sip of water.
- Arrive on time.
- Bring a list of your current medications, your photo ID, insurance cards, and your advance directive paperwork.
- Wear loose, comfortable clothing. Leave jewelry, valuables, and contact lenses at home.
After the surgery
You will be in recovery for 1 to 3 hours. For outpatient procedures, you go home the same day. For procedures requiring overnight stay, you go to the floor.
You will receive specific discharge instructions including:
- Wound care
- Activity restrictions (no bending, lifting, twisting limits)
- Medication schedule
- Signs to watch for that warrant a call to the office or ER
- Follow-up appointment dates
Read the discharge instructions before you leave. Do not just stuff them in your bag.
The five biggest mistakes I see
- Continuing to smoke up to the day of surgery. Stop early and stay stopped.
- Not arranging help for week 1. You will need it.
- Skipping pre-op physical therapy when it was recommended. Strength in matters.
- Hiding medical conditions (sleep apnea, blood thinners, alcohol use) from the anesthesia team. Tell them everything.
- Showing up financially unprepared. Settle the cost question before surgery, not after.
How our practice helps you prepare
Every surgical patient gets:
- A pre-op visit with me where we go through the whole plan
- A coordinator who walks you through pre-op testing, paperwork, and logistics
- A written cost estimate before surgery
- Direct phone access to the office for questions
- Coordinated pre-op clearance with your other physicians as needed
The point is that you are not figuring this out alone in the days before surgery.
Ready to schedule?
If you are getting close to spine surgery and want a clear, complete preparation plan tailored to your procedure, schedule a consultation at sharifspine.com. We will walk through the timeline together and make sure you are set up for the smoothest possible recovery.
About the Author
Kevin R. Sharif, MD is an Adult & Pediatric Spine Surgeon practicing in the Las Vegas Valley. Dr. Sharif completed the Norton Leatherman Spine Fellowship with training in both neurosurgical and orthopedic spine surgery, a dual-discipline fellowship profile that is unusual in the field. He is the only spine surgeon in the Las Vegas Valley with both neurosurgical and orthopedic spine fellowship credentials, the most experienced minimally invasive spine surgeon in the region, and the only surgeon in the valley performing endoscopic spine surgery. He has performed more cervical and lumbar disc replacement procedures (motion-preservation alternatives to fusion) than any other surgeon in the valley.
Learn more at sharifspine.com.