Spinal fusion is a common form of back surgery that entails the fusion of two or more vertebrae to eliminate painful motion caused by degenerated discs or spondylolisthesis. People who are deciding whether to have the procedure or who have had it already often wonder what kind of physical activity they will be capable of after surgery. The following describes both short- and long-term exercise recommendations for people who have had lumbar spinal fusion.
The First Few Months
It can take about half a year for a fusion to set. During this time, it is important to place limitations on physical activity so that the fusion process is not disrupted by jarring motions. You might think bed rest would be the best option to ensure a smooth fusion; however, low-intensity exercise is actually imperative to recovery. It is important to exercise after fusion surgery for a number of reasons:
1. Muscles supporting the spine should be kept strong.
2. The back can become stiff after surgery and stretching exercises will help maintain flexibility.
3. Movement also helps prevent the formation of adhesions or scar tissue that can damage tissues in the back.
4. Maintaining cardiovascular fitness will help deliver fresh blood and oxygen to the healing area, giving it more material to build new bone with.
5. Maintaining a healthy weight will prevent extra stress on the back.
The exact amount of activity you’re allowed will depend on what type of fusion you had, the location of fusion, the number of levels fused and your rate of healing. Make sure to discuss post-fusion exercise with your doctor or surgeon. If possible, arrange to see a physical therapist within a few days after surgery to get professional exercise advice. Generally, the following activity plan is followed after a fusion surgery.
The first week of recovery entails walking and gentle stretching of the thighs and back. Light core stabilization exercises that involve moving the arms and legs rather than the trunk may be introduced within the first few weeks. These exercises avoid any stressful movements of the spine such as twisting. As pain decreases, you’ll be able to increase the distance of your walks.
After about 6 weeks, you may be able to add more mobile exercises into your routine. After about 9 weeks, if possible, you’ll want to increase your aerobic workout to include brisk walking, swimming or another type of low-impact workout. Within the first half year to a year of surgery, you’ll need to avoid jarring activities like jogging or contact sports.
For a comprehensive list and description of post-fusion exercises, see http://www.spine-health.com/treatment/spinal-fusion/rehabilitation-following-lumbar-fusion.
Your surgeon may tell you that you can return to any activity once you’re healed if the procedure is successful. However, being physically capable of doing an activity and deciding to do it are two different things.
There is a concern with spinal fusion surgery called adjacent segmental degeneration (ASD). ASD entails the degeneration of joints and spinal discs surrounding the site of a fusion, since the disc and joints in that area are no longer absorbing shock and facilitating motion. This means that any high-impact activity you do will cause added stress on the discs and joints surrounding the fusion. The risk of ASD increases with the number of spinal levels fused.
Activities that jar the spine like running and outdoor cycling, or those that combine twisting and force like tennis or golf are, therefore, not ideal activities after having a fusion surgery. They are possible, but you must make a choice about what you’re willing to risk. When deciding whether or not to have spinal surgery, those who live athletic lives may wish to look into artificial disc replacement or lumbar dynamic stabilization surgery as an alternative to fusion due to ASD concerns.
If you’ve had a fusion, one of the best ways to stay active is in the pool. Water takes stress off joints and discs while providing the resistance your body needs to stay fit. Swimming or water aerobics are ideal for people with back problems. Another option is an exercise machine, such as a stationary bike or elliptical, the design of which prevents jarring of the spine.
Exercise after spinal fusion surgery is not only possible but necessary. Keep in mind that you will be able to lead an active life after your recovery, but that your activities may not be the same as they were before surgery.