Lumbar Spinal Fusion
Table of Contents
Lumbar Spinal Fusion
Most Common Causes of Lumbar Back Pain
Your Visit With The Surgeon
Getting Yourself Ready For Surgery
Understanding Back Precautions
Making Arrangements For Surgery
Your Hospital Visit
Lumbar Spinal Fusion Surgery
Recovery At Home
When To Call Your Surgeon
Long Term Care For Your Back
Back Precautions Do’s
Your spinal fusion has a limited range of safe motion while it is healing. For about four months following surgery, you must follow special back precautions to protect your new fusion. Your, back precautions will prevent injury to your back until it heals. While you are in the hospital, your healthcare team will remind you often of your back precautions. Once you get home, you must remember to follow these precautions until your surgeon approves motion beyond that described in the back precautions.
• Do keep a balanced, aligned position of comfort at all times. When lying on your side, place a pillow between your knees and at your back.
• Do arrange work areas so they are above your hips and below your shoulders to prevent bending, stooping, or reaching.
• Do lie down when you rest. Lying down puts less stress on your back than sitting.
• Do walk as much as a mile each day. You can walk outside, but be careful not to fall.
• Do go up and down steps, unless your surgeon tells you not to. Go slowly, and hold onto the hand rails.
• Do pace your activities so you don’t get too tired.
• Do limit visitors. Too many visitors can be very stressful.
• Do bend your hips and knees when lifting, don’t bend at the waist. Lift with your legs, not with your back.
Back Precaution Don’ts
• Don’t twist your spine when turning; turn your whole body.
• Don’t pull on the side rails of the hospital bed; this will strain your back.
• Don’t reach, stoop, or bend forward at the waist or from side to side.
• Don’t lift anything heavier than 5 pounds (a gallon of milk); hold objects close to your body.
• Don’t strain your abdomen as in coughing, sneezing, or using the toilet. (If constipation is a problem, talk with your surgeon.)
• Don’t do excessive physical activity (including sex after your back surgery) until your surgeon says it is OK.
Changing body positions while lying down helps blood circulation, prevents pressure sores, relieves muscle tension, and reduces pressure on your surgical site. Right after surgery the nurses will “logroll” you while you remain passive by keeping your body stiff and not “helping” the nurses turn you. Then you will be shown how to “logroll” to change positions while lying down and to change from lying down to sitting up. Logrolling prevents bending, twisting, and straining of your spine which could disrupt the surgical repair. Avoiding bending, twisting, and straining will protect your fusion while it heals. Bone healing starts at about 6 weeks and substantial healing occurs at about 6 months.
Following your back precautions can hinder daily activities such as dressing and bathing. However, there is special equipment to help you. The following items will make it easier and safer for you while you heal.
• A sock donner helps you put on socks without bending over too far.
• A dressing stick helps you pull clothing up over your head.
• A long handled shoe horn allows you to put on your shoes without bending over too far.
• Elastic shoe laces can turn your lace up shoes into slip-ons.
• A grabber helps you pick up things which are on the floor without bending over too far. You can also use the grabber to reach items above your head, such as from high cabinets in the kitchen or closet shelves.
• A long handled sponge makes it easier to wash while taking a shower or bath.
• A walker allows you to walk by yourself. The physical therapist can teach you how to walk with a walker if you need one.
Precautions While Sitting
Your back precautions affect where and how you should sit, and how you should get up from a sitting position. A good rule to remember when sitting is “always sit with your hips higher than your knees”. This will reduce the amount of stress on your back as you stand up. So, before surgery, check out your favorite sitting areas at home. Sit on:
• your favorite chair
• the seat of your car
• the side of your bed
• the toilet
• the sofa
Are your hips higher than your knees? If not, add a firm pillow to your seat to raise the level of your hips. You can buy or rent a raised toilet seat that has arms.
When you return home, sit in chairs that have straight backs, firm seats, and sturdy arms. When getting up from a sitting position scoot your hips to the edge of the seat, push up on the chair arms while pushing yourself up with your legs.
Lying down puts the least stress on your back. Standing puts more stress on your back than lying down. Reclining is somewhere between lying down and standing up. Sitting puts the most stress on your back. Therefore, your surgeon will tell you how long and how often you may sit after surgery. Limiting the time you spend sitting can last up to four months. However, you can recline, lie down, stand, and walk for as long and as often as you feel you can.
Your surgeon will tell you when you can drive or ride with others. Also, since sitting puts the most stress on your back, avoid sitting for long car trips. Avoid sitting in sports cars; the seats are usually low and getting in and out can put extra pressure on your back. Also, avoid vans, trucks, or sports utility vehicles that are high off the ground and hard to get into and out of.