Physical Therapy for Spinal Fusion

Spinal fusion is major surgery that may involve incisions from both the front and back for the surgeon to repair the spine. Surgeons use methods involving bone grafts, inserting hardware (rods and screws) and even a newer device, called an interverterbral cage. Every surgery must meet the special conditions presented by the patient's condition. Following surgery is a long road of rehabilitation and therapy that really never ends.

Rehabilitation

• Rehabilitation will be a slow process while the bone graft is healing. In the beginning, movement will be restricted and the patient will wear a rigid brace, potentially for months after the surgery. For the first six weeks, patients will be directed to avoid bending, lifting, twisting and even driving. However, among the first physical therapy exercises is to simply walk around in your home.

  Walking is important to ensure continued mobility and so that all the muscles do not become too weak. Because of the limited activity, some muscles will atrophy, but when physical therapy is increased, keeping those muscles active and later, rebuilding them, will all come into play.

Physical Therapy

• Some of the earlier exercises will be simple movements for mobility, to keep the muscles from freezing up. Follow your doctor's and therapist's instructions for a full recovery. Beginning therapy will teach you how to sit and stand properly. While lying in bed, it will teach you a "log-rolling" technique so that you can roll in bed without twisting your spine.

  While at home, you'll be given many exercises to do. Early therapy exercises will include tilting your pelvis and holding it. You'll stand and tilt (or rotate) your pelvis forward and hold, then release. Then you'll repeat by tilting your pelvis back. Other beginning therapy exercises including lying on your back and doing gentle abdominal crunches. It's important to keep all your muscles functioning that must support your back. In another exercise, the "dead bug," you lie on your back and raise your arms and legs into the air, then gently wave them around like a bug trapped on its back. You'll be instructed on how to stand and practice twisting your entire torso in a single unit.

  Slightly more strenuous exercises include lying on the floor in a doorway with one hip alongside the door frame. Raise that leg up and prop (or stretch) it against the door frame. You'll have to turn around so you can do the opposite leg. As you advance, you'll begin therapy using weights to regain muscle strength. You'll work out your back, shoulders and leg especially. You'll reach up and pull down weights, do weighted leg lifts, stand and press backward against weights with your shoulders and stand and press weights forward with your shoulders and upper chest.

  And you'll continue walking, but with progress, you'll be allowed to walk outside. Once you've regained full mobility, your doctor may recommend you incorporate additional exercise routines, such as tai chi. Tai chi is particularly helpful as it helps strengthen the legs and lower back and encourages proper use of the torso.