Herniated Disc Surgery Preparation: Complete Pre-Operative Checklist

Thorough preparation reduces complications and accelerates recovery after lumbar or cervical discectomy/microdiscectomy.

Pre-Operative Checklist (17 Steps)

1. Surgical Consultation – Review imaging (MRI/CT), confirm level/side, discuss technique (open vs. micro vs. endoscopic), risks (dural tear 1–3%, infection <1%, reherniation 5–15%), expectations.
2. Medical Optimization – PCP clearance; cardiology/pulmonology if indicated (CAD, COPD, OSA).
3. Pre-Admission Testing – CBC, CMP, PT/INR, aPTT, type & screen, EKG (>40 or cardiac hx), CXR (if indicated).
4. Imaging Confirmation – Recent MRI (≤3–6 mo); bring images/CD to hospital.
5. Medication Reconciliation – Hold anticoagulants/antiplatelets per protocol (ASA 7d, clopidogrel 5–7d, warfarin 5d + bridge, DOACs 24–48h). Continue essential meds (β-blockers, statins) with sip of water.
6. Anesthesia Consult – General vs. regional; discuss airway, positioning (prone on frames), neuromonitoring (MEP/SSEP).
7. Smoking Cessation – ≥4 weeks pre-op ideal; nicotine impairs wound healing, fusion (if applicable).
8. Nutrition & Fitness – Protein 1.2–1.5 g/kg/d; prehab (core, walking) improves outcomes.
9. Home Preparation – Caregiver 24–48h; raised toilet seat, grab bars, reacher, ice packs, loose clothing, pre-made meals.
10. Insurance Authorization – Pre-cert, estimated cost, out-of-pocket max.
11. Medical Records Packet – Imaging reports, labs, prior op notes, allergy list, advance directive.
12. Informed Consent – Read, sign, ask questions (alternatives, natural history).
13. Transportation – Responsible adult driver; no driving 24h post-anesthesia (or while on opioids).
14. Personal Items – ID, insurance card, CPAP (if OSA), glasses, medications in original bottles.
15. Pre-Op Hygiene – CHG shower night before and morning of (per protocol); no lotions, jewelry, nail polish.
16. Arrival Time – Typically 2 hrs before scheduled start.
17. Stress Reduction – Breathing, meditation, music; preoperative anxiolytic per anesthesiologist.

Day-of-Surgery Reminders

• NPO after midnight (clear liquids until 2h pre-op per ASA guidelines).
• Remove dentures, hearing aids, contacts before OR.
• Verify surgical site marking (surgeon initials).

Post-op: Early ambulation (4–6h), multimodal pain control (NSAID + acetaminophen ± limited opioid), stool softener, incision care, follow-up 2–3 weeks.