Recovery from Lumbar Fusion Surgery

Recovering from lumbar fusion spine surgery can be a challenging process. Fortunately, your spine surgeon will provide you specific instructions that will help make the post-operative period a bit more comfortable. Even more importantly, your surgeon’s recommendations help protect the long-term success of your low back procedure—that’s why it’s so essential to follow your surgeon’s post-operative instructions.

This article describes what to expect after lumbar fusion surgery, from post-operative activity recommendations to the warning signs that warrant a call to your spine surgeon.

Doctor visiting patient in hospital roomBefore surgery, it is important to talk to your doctor and anesthesiologist about pain management.

Surgical Dressings

When you return from low back surgery, you will have a surgical dressing over your incision. The dressing will be removed several days after your surgery. You may have stitches (sutures) under your skin, which will dissolve as healing occurs. Some patients may have stitches or staples that are visible—those are usually removed 2 to 3 weeks after surgery by a visiting nurse or in the surgeon's office.

Keeping You Comfortable

The amount and type of pain you have will vary—it may feel sharp, dull, or achy. Before surgery, it is important to talk to your doctor and anesthesiologist about pain management. Pain relief may include medication by intravenous (IV) medication at first and then an oral analgesic. If you feel the medicine is not giving you relief, please talk with your doctor or nurse.

Intravenous (IV) therapy
An intravenous line (IV) in your arm will give you fluid and nourishment. Once you resume eating and drinking, these IV fluids will be stopped. Depending on the type and extent of your surgery, you may receive an antibiotic through your IV every few hours for several days after your operation to prevent infection. The IV should not be painful. If it is, let your nurse know so that he or she can check it.

Diet
You will be allowed to have ice chips or small sips of water for the first 24 to 36 hours or until your stomach is ready for food. You will progress from liquids to regular food as soon as you are able to tolerate eating. Some patients will not be allowed to eat or drink for 24 to 48 hours.

Medications
In addition to medications you were taking before surgery, a laxative and sleeping medication will be available to you if you need them. Please ask your nurse or doctor any questions or concerns you have about your medications.

Preventing Breathing Problems

It is important to practice deep breathing exercises after your surgery to help prevent respiratory complications. Below are examples of these exercises:

  • Place your hand on your stomach. Breathe in through your nose. Notice that your stomach rises and your chest expands. Hold your breath for 2 seconds. Breathe out through your mouth. Notice that your stomach goes down. You should always cough following the deep breathing exercises. This will help clear your lungs.
  • Take several deep breaths. On your next breath, breathe in through your nose and hold your breath for 2 seconds. Then cough 2 or 3 times in a row. You may need to do several “double coughs” to clear your lungs.
  • Your nurse will also teach you how to use an incentive spirometer, a device that helps you to breathe deeply. You should use this 10 times an hour while awake.

Preventing Circulation Problems

Maintaining good circulation in your legs after spinal surgery is very important. You can help your circulation by doing your leg exercises and walking. You may also wear sequential compression boots that automatically inflate and deflate, helping to pump the blood in your legs back up to your heart.

Activity Following Lumbar Fusion Surgery Positioning

Depending on the complexity of your lumbar surgery, you may be allowed to sit up with assistance on surgery day. Some patients remain in bed on the day of surgery. The nurse will help you "logroll" from side to side as needed to prevent stiffness and promote good circulation. Logrolling is turning your hips and shoulders at the same time without twisting your back.

You may have a pillow placed under your knees to decrease stress on your back. You should not lie on your stomach, as this can cause unnecessary strain on your back. You should ask for help when you feel ready to change your position.

Moving In and Out of Bed
When you are allowed to get out of bed, the nurse will assist you.

To get out of bed:

  1. Logroll to the edge of the bed.
  2. Lower your feet over the edge of the bed and push on your elbow to get to a sitting position while keeping your back straight. To get back in bed, sit on the edge of the bed.
  3. Lower yourself onto the bed on your side, coming down on your elbow. As you do this, lift your feet into the bed.
  4. Once you are lying down, you can logroll onto your back or other side.

Activity Out of Bed
Below are good rules of thumb when it comes to activity after lumbar fusion surgery:

  • It is good to take short walks in the hallway. Remember though, walking should not increase your back pain or cause leg pain.
  • When you are sitting, choose a firm hardback chair.
  • Don't sit for longer than 20 minutes at a time. It is better to walk around or lie down to rest.
  • Do not bend or lift.
  • If you must stoop, bend your knees and keep your back straight while stooping and straightening up.

Exercises

Your post-operative exercise program will vary depending upon what your doctor prescribes and your type of surgery. Your physical therapist assists you with prescribed exercises that are safe, including the number of sets (eg, 10 times) and how often these movements should be performed.

Ankle pumps
While lying on your back or sitting, move your ankles up and down as far as possible without moving your legs. This helps your circulation.

recovery from surgery ankle pumps drawings exercise todd albert

Quadriceps setting exercises
While lying on your back, tighten your thigh muscle by pushing the back of your knee down onto the bed. Hold for a count of 5 seconds and relax.

recovery from surgery quadriceps setting drawings exercise todd albert

Gluteal setting exercises
While lying on your back, squeeze your buttocks together. Hold to the count of 5 and relax.

recovery from surgery gluteal setting drawings exercise todd albert

Post-operative Lumbar Spine Bracing

Depending on the complexity of your surgery and the spine surgeon’s orders, you may need to wear a back brace. The size, shape and construction of the brace is customizable to fit (eg, Velcro closures) your body and to provide sufficient strength to immobilize and support your low back.

It's advisable to wear a cotton tee shirt under your brace for comfort and to help reduce potential incision irritation. Your spine surgeon and/or his nurse will provide you with specific instructions regarding how to wear the brace and for how many hours per day, as well as brace care.

Lumbar Fusion Surgery Discharge Instructions for Home Care

Incision care
Your incision may be covered by many strips of paper tape (Steri-Strips). Do not pull the strips off from your incision and do not get them wet until you are allowed to shower. The strips help to keep your incision closed during early healing. If you have visible sutures or staples, they will be removed about 2 weeks after surgery either by the home care nurse or during a post-operative follow-up appointment with your spine surgeon.

If your spine surgeon allows, you may shower and wash your incision with a mild soap and water and rinse thoroughly. However, you should not take tub baths, go in a swimming pool, or immerse your incision in water in any way until permitted by your doctor.

Activity
Activity is a very important part of your recovery. Walking is the best way to recuperate and heal tissue. There are no restrictions for walking or stair climbing.

  • Avoid sitting for long periods of time. Sitting is recommended for 20 minutes 3 times daily, preferably for meals.
  • Avoid bending and twisting motions. You should not lift any objects heavier than 10 pounds for the first month at home.
  • You may not drive, but you can take short car rides (no longer than 20-30 minutes).
  • You can resume sexual activity when you are comfortable (usually 6 weeks).

Medications
A prescription for pain medication, if needed, will be provided at the time of discharge.

First post-operative visit
The first post-operative visit should be scheduled for 4 to 6 weeks after discharge from the hospital.

When to Call Your Doctor During Lumbar Fusion Recovery

Please call your doctor if you notice any of the following symptoms:

  • Increase in redness, swelling, warmth or tenderness of your incision, or drainage from your incision.
  • Flu-like symptoms, including body temperature above 101.5 degrees F for more than 2 days.
  • Numbness, tingling, or change in sensation in your legs.
  • Difficulty controlling your bowels and/or bladder.

Even if you don’t have these symptoms, don’t hesitate to call your surgeon if you are worried or have questions about the progress of your lumbar fusion recovery.

Updated on: 06/13/18
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Surgery Recovery: From Hospital to Home
Although Dr. Albert states the first postoperative visit is scheduled for four to six weeks following discharge from the hospital, many physicians see patients prior to that time. Since wound healing is a concern, the first postoperative visit may be scheduled before the four to six week time frame. Typically during the first visit following surgery, postoperative goals and incisional healing is addressed.
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Surgery Recovery: From Hospital to Home

The first part of recovery from spine surgery begins in the hospital.
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