Question 1

How long does surgery take?

Accepted Answer

It varies by procedure and complexity. Most of the minimally invasive and endoscopic procedures Dr. Hirsch performs take between 45 minutes and two hours. More complex reconstructions involving multiple levels or prior surgery take longer. You will receive a specific estimate during your consultation.

Question 2

How do I know if I actually need surgery?

Accepted Answer

Most spine conditions are treated without surgery first. Dr. Hirsch's approach is to recommend surgery only when conservative treatment has been appropriately tried and has not provided adequate relief, when neurological function is at risk, or when imaging shows a problem unlikely to improve on its own. If surgery is recommended, the reasoning will be explained clearly — and you are never pressured to proceed.

Question 3

What is the difference between spinal cord compression and nerve compression?

Accepted Answer

These are distinct problems with different implications. Nerve root compression — the more common of the two — causes pain, numbness, or weakness in a specific arm or leg pattern depending on which nerve is affected. Spinal cord compression, known as myelopathy, affects the cord itself and produces more diffuse symptoms: hand clumsiness, balance problems, and in advanced cases, bladder or bowel changes.

Question 4

Can I take supplements or herbal medications before surgery?

Accepted Answer

Most supplements should be stopped seven to ten days before surgery. Many — including fish oil, vitamin E, ginkgo, garlic, and turmeric — have blood-thinning properties. Others can interact with anesthesia. When in doubt, stop taking it and let us know what you were using.

Question 5

Do you offer telemedicine visits?

Accepted Answer

Yes. Many spine problems can be evaluated remotely as long as we have your imaging to review and can talk through your symptoms by phone or video. This also gives patients outside Newport Beach and Carlsbad access to a subspecialist who may not be available locally. Both first visits and follow-ups can be done virtually if that's more convenient.

Question 6

Will I be paralyzed from surgery?

Accepted Answer

It's highly unlikely, though not impossible, which is why neuromonitoring tracks the health of your spinal cord and nerves throughout every procedure.

Question 7

What are the risks of surgery?

Accepted Answer

Every surgery carries risk, and it's worth understanding them before you decide to proceed. The main ones are related to anesthesia, infection, nerve injury, and spinal fluid leak. Modern anesthetic technique and short surgical times keep anesthesia risk low. Infection risk is reduced by antibiotics and by the controlled surgery-center environment. Nerve injury is a risk specific to working this close to the nerves being treated, which is why real-time neuromonitoring tracks nerve signals throughout every case. Spinal fluid leak is uncommon, and the high-resolution magnification used during surgery makes it easier to avoid the thin lining that surrounds the nerves in the first place. Dr. Hirsch will walk through the specific risks relevant to your procedure during your consultation.

Question 8

How long is recovery?

Accepted Answer

Recovery depends on the procedure, but for most of Dr. Hirsch's surgeries it follows a similar arc. Week one: rest, short daily walks, and limited bending and twisting, with no sitting longer than an hour at a time. Week two: longer walks, and most patients return to office-based work around day ten. The first follow-up visit happens around day fourteen. Week three: light work around the home and low-impact cardio such as a stationary bike or elliptical. Lifting restrictions last longer — four to eight weeks depending on the procedure. Fusion patients carry the longest restrictions; endoscopic patients the shortest.

Question 9

When can I drive after surgery?

Accepted Answer

Not while you are taking opioid pain medication or muscle relaxants. Once you are off them, return to driving when you feel comfortable controlling a vehicle. Every patient is asked to start with a practice run — a short drive down your own block with another adult in the car. After fusion procedures, driving is typically cleared at the two-week postoperative visit.

Question 10

How much can I lift after surgery?

Accepted Answer

Every procedure carries a lifting limit during early healing. As a general range: five pounds after lumbar fusion, ten pounds after endoscopic and posterior cervical procedures, and fifteen pounds after disc replacement and anterior cervical fusion. Restrictions last four to eight weeks depending on the procedure, and fusion patients also avoid repetitive bending and twisting for up to eight weeks while bone heals. Your written instructions state your exact limit.

Question 11

When can I start walking and exercising?

Accepted Answer

Walking starts in the facility, often within an hour of coming out of surgery — early movement lowers the risk of blood clots and pneumonia, reduces stiffness, and improves mood. Begin with one to two blocks or ten to fifteen minutes at a scheduled time each day, and add distance daily. Around week three, most patients add low-impact cardio — treadmill walking, elliptical, or stationary bike. Everything else comes back gradually: low intensity and short duration first, then build if your body responds well.

Question 12

When can I return to work?

Accepted Answer

If your job is office-based, about ten days for most procedures — and as little as three days after kyphoplasty. Physically demanding jobs are a different conversation: return timing is decided at your first postoperative visit based on how you are healing.

Question 13

Will I need physical therapy after surgery?

Accepted Answer

For most procedures, yes — at some point during recovery. The timing varies by procedure. Dr. Hirsch will outline the rehabilitation plan before your surgery so you know what to expect and when to begin.

Question 14

When can I fly after surgery?

Accepted Answer

Short-haul travel is generally permitted within one to two weeks of most minimally invasive procedures. Long-haul international travel requires a specific discussion given the risk of blood clots with prolonged immobility. Many of Dr. Hirsch's out-of-state patients travel home within a few days of surgery — this is planned for in advance during the preoperative conversation.

Question 15

Will I need a collar or brace after surgery?

Accepted Answer

It depends on the procedure. After anterior cervical fusion, a soft collar is optional — wear it if it makes you more comfortable, skip it if it is more hassle than help. After posterior cervical fusion, a rigid collar protects the instrumentation and is worn full-time for six weeks, removed only to eat, sleep, and bathe. Disc replacement and endoscopic procedures typically require no bracing at all.

Question 16

Will I have stitches or staples that need to be removed?

Accepted Answer

For nearly all procedures, no. Incisions are closed with dissolvable sutures under the skin and sealed with surgical glue or adhesive strips. The strips may discolor, flake, or peel over the first weeks — that is expected and requires no action. If you notice drainage or spreading redness at the incision, call the office.

Question 17

When can I shower? What about baths and pools?

Accepted Answer

You can shower with the surgical dressing in place from the first day home. The dressing comes off between two and seven days after surgery depending on the procedure, and after that you shower with the incision uncovered. Baths, jacuzzis, pools, and the ocean wait until the incision has been checked at your first office visit.

Question 18

How do I manage pain after surgery?

Accepted Answer

Most patients are surprised by how little pain they have after minimally invasive procedures. A short course of oral pain medication covers the first two weeks, with a simple philosophy: use it when you need it, wean off as quickly as your pain allows. After endoscopic procedures, most patients need prescription medication for only a day or two. A stool softener is prescribed alongside, since anesthesia and opioids cause constipation, and medication should be taken with food. Patients who already see a pain management physician resume prescriptions through that physician within the first two weeks.

Question 19

Should I use ice or heat after surgery?

Accepted Answer

Ice is appropriate in the early post-operative period to reduce swelling around the surgical site. After the first few days, heat can help with muscle soreness and stiffness. When in doubt, use ice over the incision area and heat away from it.

Question 20

How big is the incision? Can I help the scar heal?

Accepted Answer

Endoscopic procedures use a dime-sized incision or smaller. Fusion and disc replacement incisions are slightly larger but significantly smaller than traditional open surgery. Once the wound is fully closed and dry — typically around two weeks — silicone scar gel or strips can support healing. Avoid direct sun exposure on the scar for the first year.

Question 21

Why is swallowing difficult after neck surgery?

Accepted Answer

After anterior neck surgery — cervical fusion or disc replacement — throat discomfort and difficulty swallowing are common and can persist for six weeks or more, improving with time. Start with small quantities, spend more time chewing than usual, favor softer foods, and avoid carbonated beverages until swallowing feels normal. If you cannot swallow liquids, call the office.

Question 22

Will I set off metal detectors?

Accepted Answer

Not likely. The amount of metal in modern spine implants is not typically enough to set off a metal detector.

Question 23

Should I see a dentist before or after surgery?

Accepted Answer

We recommend completing any necessary dental work before surgery. After spine surgery involving implants, let your dentist know you have spinal hardware — some circumstances may require antibiotic coverage before invasive dental procedures, and your dentist should make that determination.

Question 24

What if I have a concern after hours?

Accepted Answer

Call the office at (949) 781-4704 and leave a message — voicemail is monitored, including nights and weekends, and postoperative messages are checked frequently. For emergencies such as chest pain, difficulty breathing, loss of bladder or bowel control, or rapidly progressing weakness, go to the emergency room.

Frequently Asked Questions

Before Surgery

Recovery & Activity

Incisions, Medications & Practical Questions

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