The only time your surgeon may recommend lying flat in bed is if there is a leak of cerebospinal fluid (CSF) at the time of surgery and a repair has been performed. Loss of cerebrospinal fluid can cause spinal headaches. Laying flat helps prevent headaches as one’s body produces more cerebrospinal fluid. Luckily this is rare and typically only a short term (24-48 hour) requirement. In general, you can have your head up immediately following surgery. However, remember to keep a neutral spine posture. When the bed is flat, you can lie on your side with your knees drawn up and a pillow between your knees as well as under your head, or on your back with a pillow under your head/neck and knees.