Rehabilitation program following spinal surgery

REHABILITATION PROGRAM AFTER LUMBER FUSION

First phase of rehabilitation (0-6 weeks after surgery)

During hospitalization, the physiotherapist will educate the patient on breathing exercise, static exercise of the lower and upper extremities so the patient can get in and out of bed on his or her side and put on the orthosis. Sitting up to 20 minutes multiple times per day is allowed. What is not allowed in the next 6 weeks, though, is flexing the trunk forward and backward, rotation and carrying heavy loads.

Second phase of rehabilitation (6 -12 weeks after surgery)

In this phase of recovery, and in agreement with the surgeon, the orthosis is not needed anymore. Minimal movement of the spine are allowed (limited flexion forward, backward and to the side). The patient begins exercising in the pool, with stabilization exercise on the stomach and back. Balance, proprioception and strength exercise are also included. Functional activities need to be done on a neutral and protective surface to reduce the stress on the lumbar spine.

Third phase of recovery (3-6 months after surgery)

After the control examination by the surgeon and functional report, further rehabilitation dynamics are continued. 3 months after surgery, the muscle training is intensified with emphasis on deep trunk stabilizers. Exercise with minimal resistance are allowed, exercise on an exercise ball are introduced, as well as swimming and dynamic pool exercise. Spine movements in the direction of flexing forward, backward and to the side intensify. When the satisfactory condition is achieved, younger patients begin with running on the treadmill and with functional training.

REHABILITATION PROGRAM AFTER LUMBER MICRODISCECTOMY

First phase of rehabilitation (0-6 weeks after surgery)

In the first four weeks until postoperative pain reduces and soft tissue heels, caution while doing some activities is needed. The functional activity is gradually increased, in respect to postoperative pain, tissue healing and the condition of the patient. During hospitalization, the physiotherapist will educate the patient on breathing exercise, static exercise of the lower and upper extremities so the patient can get in and out of bed on his or her side and put on the orthosis. Sitting up to 15-20 minutes is allowed. Long car drives should be avoided, as well as flexing the trunk forward and why lying, trunk rotation and carrying heavier items (up to 2kg). The duration of the walk depends on the general condition of the patient. Walking multiple times a day up to 30 minutes is advisable.

Second phase of rehabilitation (6 -8 weeks after surgery)

In this phase of recovery, exercise devoted to mobility of the whole spine along with dynamic exercise for the paravertebral muscles and deep trunk stabilizers are introduced. Balance, proprioception and strength exercise are also included. Functional activities need to be done on a neutral and protective surface to reduce the stress on the lumbar spine. Swimming is allowed.

Third phase of recovery (8-12 weeks after surgery)

Two months after surgery, jogging is allowed. According to the degree of physical condition, the physiotherapist will compose a small, medium or high intensity exercise program. Patients of younger age and athletes will have a program of functional training which will contain high intensity exercise of strength, flexibility, stabilization, trunk control, proprioception and coordination. Patience of average and reduced physical condition will have a program according to their condition.