Project Description

Lumbar fusion

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Have you recently had a lumbar fusion? Maybe you have been told you need one and want to try to avoid it? Or maybe you have been told to get stronger before your operation?

At Complete Pilates we see hundreds of people who tell us the same thing.

Meet Mr Alexander Montgomery. Below, he is answering all the questions we hear on a daily basis in the studio and online! Remember, if you want to know more just ask us.

We are trying to make your rehabilitation and treatment as clear as possible so have put together this patient information handout. Please feel free to contact us if you have any questions.

In the spine, each vertebra is separated by discs and cartilage (see the spine handout) which normally move against each other. This is the reason we have spine mobility.

A spine fusion is an operation which takes away the mobility between two of these vertebrae by removing the discs and cartilage, inserting metalwork (normally screws, rods and cages), and encouraging the two vertebrae to become one by growing bone between them.

You would only be suitable for a fusion if you have not responded to any other form of treatment. This includes Physiotherapy, appropriate one to one Pilates, pain management, and injections.

It is only completed if it is thought that the source of your pain arises from the movement between the two vertebrae.

In short, yes. Although two of the vertebrae are fused together, it is important that the rest of your spine moves well.

When you can get up and walk depends on exactly what has happened during the operation. Your Consultant will discuss with you their post-operative guidelines, the exact operation that you have had, and how many levels have been fused. You may get the opportunity to get out of bed the same day, but otherwise the aim is to get up and walking the following day.

Over the two weeks following your surgery, you will be expected to gradually increase your mobility. At this point you will be expected to go to clinic to have your post-operative follow up appointment.

This obviously depends on the nature of the fusion and how many levels were fused together. The best thing to do is to ask your Consultant directly.

In general, for a one level operation you will be encouraged to walk as soon as possible. The inpatient hospital Physiotherapists will then give you basic stretches and exercises to complete for the first few weeks.

The wound takes approximately two weeks to heal and shortly after this you will be asked to start Physiotherapy. Patients are often capable of going to one to one Pilates classes with an appropriately trained instructor at 3-4 weeks. Ideally, by week four you are on an exercise bike in the gym, and your rehabilitation will progress from there.

When you go back to work depends on the nature of the surgery, your job, and your commute, but is typically around 5-6 weeks. However, you must check with your Consultant whether the fusion is a one stage, or two stage procedure.

Yes. You will be encouraged to walk as soon as possible and do the exercises that the Physiotherapists in hospital give you. However, this does not mean that you can go home and start HIIT classes or start going to the gym.

When and how you progress your movement depends on the nature of the surgery, how many levels are done, and your general fitness levels. Physiotherapy, or appropriate one to one Pilates is encouraged by week 3. The aim is to slowly increase your activity from then onwards, which will be directed by your Physiotherapist.

Most of the time big scars can be avoided as minimally invasive techniques are used to reduce the amount of muscle cutting. Most people are suitable for minimally invasive surgery, but it does depend on how many levels need to be operated on.

For lumbar spine fusions, there is often a small scar at the front of your stomach below the belly button, with one or two small scars in the lower back. However, sometimes there is only one scar which is in the lower back.

For neck fusions there is normally a small scar at the front of the neck which can sometimes be hidden in the natural creases. Occasionally there is a scar in the back of your neck as well.

As ever it depends on the technique being used, nature of your fusion, and the number of levels done.

Often surgery in the lower back is done in two stages. Often the first stage is through the front of your abdomen, and the second through your lower back. These operations are normally done one or two weeks apart.

Each operation will keep you in hospital on average a couple of nights. However, some patients do go home after one night after the first procedure. If you are only having a one stage operation you are often in hospital 2-3 nights.

Make sure to check with your Consultant which type of operation you are having.

We hope you have found this useful but if you do have any questions please just ask

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