How to Prepare for Spinal Fusion Back Surgery?
Spinal fusion is often performed in conjunction with spinal decompression surgery for various spinal conditions. Decompression surgery alleviates pressure on pinched nerves that extend from the spine. This process reduces pain and restricted mobility stemming from nerve compression.
Unfortunately, spinal decompression also involves removing portions of the vertebrae. This makes the spine weaker and less stable at the affected segment. To prevent further injury, spine specialists commonly use spinal fusion to stabilize the spine after decompression.
Spinal fusion involves fusing two or more adjacent vertebrae into a single bone with a bone graft. As a major surgery, spinal fusion requires extensive preparation and recovery to achieve the best possible results.
What Should You Do Before Spinal Fusion Surgery?
The process of preparing for spinal fusion surgery is similar to preparing for any other spinal operation. However, there are a few specifics to be aware of.
How To Prepare For Lumbar Spinal Fusion?
Firstly, be prepared to undergo a thorough examination before the surgery. This is essential for your physicians to plan every aspect of the operation. Radiograph assessments for spinal stability, electromyography (EMG) for nerve function, and an MRI, CAT, or other imaging tests to identify nerve compression are often performed.
Your doctors will also assess your overall physical condition to ensure that you’re in sufficient health to undergo the rigors of the surgery. You’ll need to discuss all pre-existing medical conditions with your physicians. These conditions may need to be further evaluated before proceeding with spinal fusion surgery.
With this in mind, one of the most important ways to prepare for spinal fusion is to get into the best possible physical condition. This may involve quitting smoking, improving your diet, and increasing your physical fitness (while following all of your doctor’s instructions). Being in good physical condition translates into fewer complications during surgery and a faster recovery afterward.
Physical Therapy Before and After Fusion Surgery
Physical therapy before and after fusion surgery has different goals.
Before fusion surgery, you and your PT will work to prepare the body for surgery by improving mobility, strengthening the muscles surrounding the spine, and staying active without straining the spine. Your PT can also provide valuable preoperative guidance to help you hit the ground running toward recovery after the surgery.
After fusion surgery, the primary goal of physical therapy will be to regain strength, mobility, and overall function. Your PT can also help with natural pain management and advise ways to move without straining the spine.
Along with stretches, strengthening exercises, and hands-on therapy (like massage and joint mobilization), many physical therapists offer alternative therapies to foster healing. Examples include:
- Electrical stimulation
- Ultrasound
- Heat and cold therapy
- Biofeedback
- Acupuncture and dry needling
How To Equip Your Home For Better Recovery After Spinal Fusion
Most patients are cleared to return home two to four days after spinal fusion. Make sure to plan ahead and have someone drive you home from the hospital. Typically, patients aren’t allowed to drive for a few weeks after lumbar fusion.
There are several ways to equip your home for smooth spinal surgery recovery. Our best tips include:
- Plan for simple meals after the surgery. Consider subscribing to a grocery delivery service or, better yet, a meal kit service. Many meal kits require little to no preparation and are delivered straight to your doorstep. This will help simplify your meals after the surgery.
For a DIY version of delivery meal kits, consider meal prepping before the procedure and placing the dishes in the freezer. When you’re at home post-fusion, you can defrost the meals to stay nourished without the need to cook.
Keep in mind that the ideal post-spinal surgery diet should be high in protein and fiber. Additionally, try to avoid processed foods and stick with whole grains, nuts, seeds, beans, lean protein, fruits, and vegetables.
- Purchase ice packs and heating pads, if you don’t have them already. Both cold and heat therapy are useful after spinal surgery. Cold therapy can help alleviate inflammation, while heat therapy can help ease muscle tension.
Make sure to take your doctor’s advice for heat and cold therapy, and limit your use to 15 to 20 minutes at a time.
- Consider a walker or cane. Moving around your home can be difficult in the early days and weeks after fusion. A walker or cane can help provide stability and prevent accidents.
- Place everyday items in an easy-to-access location that you won’t need to twist or bend over to reach. You can also consider purchasing a reacher/gripper/grabber device, which will help you retrieve items without straining your spine.
- Prep the bathroom with a toilet riser and shower seat or mat. These devices will make it easier to use the toilet and to spend more time in the shower, which can help alleviate pain and tension.
- Sleeping can be difficult after spinal fusion. To make it easier, consider purchasing a body pillow, which may help you find more comfortable sleeping positions.
Adaptive Equipment for Post-Fusion Recovery
Adaptive equipment can provide extra support for your post-fusion recovery, helping you complete essential tasks without bending or twisting the spine. Different tools serve different roles; while you may not need all of them, evaluating your options in preparation for surgery can ensure your recovery is as smooth as possible.
Examples of commonly used equipment after spinal fusion include:
- Extra-long shoe horns and sock aids
- For putting on socks and shoes
- Reacher and grabber tools
- For retrieving items from the floor or high shelves
- Dressing sticks
- For dressing and undressing
- Handheld showerheads
- For bathing
- Canes and walkers
- For assisted walking and moving
- Bed rails
- For getting into and out of bed
- Leg lifters
- For moving legs into and out of the bed or the bathtub
Timeline: The Fusion Healing Process
The timeline for the fusion healing process can differ from patient to patient, often based on age, overall health, and the procedure specifics. But here’s a general outline:
- Day one to day four: Resting in the hospital and working with a care team to regain basic function
- Week one to week four: Resting at home with gentle movement; start working with a physical therapist
- Week two to week four: Return to light, non-physical work (like desk jobs) and driving
- Week six to week eight: Return to moderately active work
- Month three to month six: Gradual return to more physical activity, with fewer restrictions on spinal bending and twisting
- Three months or longer: Return to physically intense work (if at all)
- Month six to month 12: Most patients fully recover from spinal fusion after a year, but you may still need to avoid certain activities.
Long-Term Activity Restrictions After Fusion
While your surgeon can provide personalized guidelines for you to follow, long-term activity restrictions after fusion often include:
- Heavy lifting, like intense weightlifting sessions or moving furniture
- Spinal bending and twists, particularly at the waist
- Repetitive movements, especially if they involve the spine
- High-impact exercise, like running and contact sports
How Many Years Does a Spinal Fusion Last?
The results of spinal fusion are permanent. This means that the affected vertebrae are permanently fused and can’t be separated. However, there are some instances in which patients require revision surgery, including:
- Fusion failure
Fusion failure occurs when the targeted vertebrae fail to combine into a single bone after the procedure. When this occurs, the patient will continue to experience back pain and neurological symptoms. Patients who have used corticosteroids are at a higher risk of fusion failure, as are patients who underwent fusion without fusion hardware.
- Hardware failure
Hardware is often used during spinal fusion to stabilize the bone graft. Rarely, this hardware may become damaged or malfunction after the procedure. In these cases, the hardware may move around and irritate the neighboring tissue, leading to pain.
- Adjacent segment disease, or ASD
Adjacent segment disease can develop when the vertebrae adjacent the fused segment break down at a faster-than-usual rate. Since the fusion eliminates all motion at the fused segment, the adjacent vertebrae must undergo added strain. Adjacent segment disease can lead to back pain and neurological symptoms, creating the need for revision surgery.
- Scar tissue
The body produces scar tissue during its natural healing process. Generally, scar tissue doesn’t cause any problems. However, after spinal procedures like spinal fusion, scar tissue may irritate or constrict a nerve root, which can cause neurological symptoms.
What Are The Long-Term Effects of Spinal Fusion Surgery?
In a perfect world, spinal fusion surgery would rid all patients of chronic back pain without future complications. But, in reality, spinal fusion creates the risk of various complications later in life.
Can spinal fusion cause problems later in life?
Future complications that may result from spinal fusion surgery include:
- Adjacent segment disease
- Spinal muscle injury, which may lead to instability and further injuries
- Chronic pain at the bone graft site
- Spinal nerve damage
- Poor spinal mobility at the site of the fusion, which can limit patients’ activities
Alongside chronic pain, poor mobility is a major concern among patients facing spinal fusion. Without the ability to bend, flex, or twist at the fused segment, many patients lose the mobility required for their favorite activities. Some patients may always need a reacher device to pick up items off of the floor.
With these possible complications in mind, spinal surgery of any kind, including spinal fusion should only be considered a last resort. Physicians only recommended it if more conservative treatments have proven ineffective.
Regain your mobility with Premia Spine! Contact us now
David danced at his son’s wedding Bonnie explains why TOPS surgery was the right decision for her Wade is back to hiking Scott speaks about going to surgeryWhat are Patients Saying?
Understanding Bone Graft Options for Fusion
Multiple bone graft options for fusion are available, including:
- Autografts, which come from the patient’s body, are usually the preferred option as they provide the highest likelihood of a successful fusion.
- Allografts, which come from donor tissue, don’t require a second surgical site like autografts.
- Synthetic bone grafts are derived from manufactured materials. With this option, there’s no limit to the bone supply and no risk of disease transmission, although they often require additional materials (like bone marrow aspirate) to encourage a successful fusion.
All bone graft options have distinct pros and cons. Your surgeon can help you better understand which options you’re a candidate for, and which are likely to yield the best outcomes.
Are Lumbar Spinal Fusion Alternatives Available?
Considering the prominent downsides of spinal fusion, it’s unsurprising that many patients with spinal conditions seek out alternative treatments. Now, patients undergoing spinal decompression have an alternative procedure to consider.
The TOPS (Total Posterior Solution) System has long been used in Europe and Australia, with better outcomes than spinal fusion. Now, it’s being used across many states in the U.S. and has earned the FDA breakthrough designation.
TOPS is a non-fusion lumbar spine implant that stabilizes the spine without eliminating the independent motion of the individual vertebrae. With TOPS, patients recover with far fewer restrictions and in a much shorter time frame than with spinal fusion.
One of the best ways to prepare for spinal fusion is to discover if an alternative solution like the TOPS System from Premia Spine makes more sense than spinal fusion for you or a loved one. Contact your spinal specialist to learn more about all of the treatment options available today.
