You have had or are about to have a spinal fusion of your spinal cord (neck to lower back),and you are wondering whether movement is forbidden in the weeks following surgery?
Are any movements banned for life? When should rehabilitation begin?
I will rely on my knowledge as a diagnostic radiographer and research into scientific studies published on the subject.
Happy reading!😀
Any questions? remarks? Let’s meet in the comments section at the end of this article.🙏
Last updated: March, 2025. Written by Juliet Semakula, a diagnostic radiographer.
▶️What is a spinal fusion?
This is a type of surgery done to any part of your spine vertebrae bone to connect two or more bones in the spine.
When these bones are connected movement may be restricted and pain is usually reduced.
In the UK, the rate of different spine fusion especially the lumbar is increasing; in 2009-2010, 4036 surgeries were performed, increasing by over 60% to 6547 by 2012-2013.
A similar trend of escalating spine fusion is reported in the USA, particularly in patients over 60 years of age
Greenwood, 2016
There are many reasons why your doctor may require a spinal fusion, but the most common ones are:
🟡If you have got damage to the spinal disk from an injury for example fracture, herniated slipped disk.
🟡Spinal weakness or instability especially if your have severe arthritis in the spine or infection in the bones
🟡If your shape of the spine has an abnormal curvature such as scoliosis, spinal fusion can help correct the problem.
🟡Pinched nerve in the neck or lower back pain.
🟡Tumour in your spine column
▶️What type of spinal fusion am I talking about here?
1️⃣Lumbar spine fusion is a major surgery designed to stop the motion of a painful vertebral segment in the lower back.
2️⃣Cervical spine fusion is done to the one or two vertebrae bones of your neck to help stabilize any injuries.
3️⃣The thoracic spine is the centre part of the spine and is formed of 12 vertebrae. Thoracic spine fusion is when two or more bones (vertebrae) of the thoracic spine are joined.
X-ray Images showing different spine fusion surgery of the cervical, lumbar and thoracic spine.
To reassure you: spinal fusion surgery is usually safe and done by specialist surgeons but as with any surgery there are always possible risks.
♦️You will be given anaesthesia to help with pain during the procedure, so you will not feel any discomfort.
♦️ Your surgeon will make a small incision, often on your side or back and place bone or a bonelike material in the space between two spinal bones.
♦️Metal plates, screws or rods are used to hold the bones together. Helping the bones to fuse and heal as one bone.
Usually, an x-ray is requested after the surgery to see how well the screws and plates are sitting, if everything is in position.
▶️Common possible complications after spinal fusion
♦️Infection.
♦️Poor wound healing.
♦️Bleeding.
♦️Blood clots.
♦️Injury to blood vessels or nerves in and around the spine.
♦️Pain at the bone graft site.
♦️Return of symptoms.
▶️What precautions are often given after a spinal fusion surgery.
After your operation you will be given verbal and written precautions to help with your recovery which normally could take 1 to 3 months after the operation.
Depending on the location and extent of your surgery, and the surgical term you have come across your instructions can vary.
You may stay in hospital 2 to 3 days or more depending on how you feel and what your doctor recommends.
It is normal to experience some pain and discomfort after the operation
You must follow all your doctors’ instructions carefully; this will help to speed up your healing.
They might not want you to take certain over-the-counter medicines for pain. Some of these can interfere with bone healing.
🟣You will be given pain medicines usually to control your pain while at home.
🟣Some teams may prohibit certain positions or gestures for example you may be advised not to carry anything weighing more than 5 kg for at least 6 weeks.
🟣While at home if you notice any signs of infection, a change in colour around the wound red, purple or brown, fluid from the wound, chills that cause shaking or a fever higher.
Please seek immediate medical care, get yourself checked by your doctor if you are worried or not sure what you are experiencing after the surgery.
▶️Examples of resumption of movement and physiotherapy after cervical fusion
Following your operation your neck will be stable, and movement will not cause damage
🟠Wear a cervical collar for 2 weeks to limit excessive movement.
🟠You may be given permission to walk from the day after the operation if you have no major pain.
🟠Gentle movement of the neck spine will be allowed for functional activity. It is not recommended that you force these movements.
🟠Physiotherapy will normally begin after 6 weeks after the operation.
🟠Try not to do too much quickly for example heavy housework, vacuuming.
▶️Movement and rehabilitation after a lumbar fusion
Postoperative management after lumbar fusion commonly focuses on analgesic pain control and activities of daily living
Identifying rehabilitation strategies to improve function and quality of life following Lumbar spinal fusion is very important.
Usually after 3 months, exercise therapy is often implemented. You will be given a home therapy exercises program focusing on:
🟠Your Pain.
🟠Contingent training of back or neck
🟠Abdominal and leg muscle functional strength and endurance, stretching.
🟠Cardiovascular fitness
Abbott,2010
🟠Physiotherapy will normally begin after 6 weeks after the operation
However, a study by Greenwood ,2016
Stated that rehabilitation of a lumbar spinal fusion commenced 3 months after surgery showed a greater outcome measures of low back pain in patients who got physiotherapy supervised exercises over a period of 8 weeks
A follow up done by Abbott,2010, of over 107 patients, aged between 18 to 65 years showed:
93% at 12 months and 81% at 2 to 3 years after surgery. Psychomotor therapy improved functional disability, self-efficacy, outcome expectancy, and fear of movement/(re)injury significantly more than exercise therapy at respective follow-up occasions (Abbott,2010)
🟠You may be advised not to wear a lumbar belt or corset after the operation
🟠Patients were restricted from activities such as contact sports, running, heavy lifting, and outer-range lumbar spine movements during the first 6 months after the operation
▶️What is the recovery timeline for bones in a spine fusion
Complete healing takes between 6 months to 1 year to fully recover from a spinal fusion because it involves bone healing, bone tissue and soft tissue. Which all needs a longer time to heal.
Spinal fusion recovery normally occurs in stages from post operative period to the final phases of healing.
| Phases | Estimated recovery timeline. |
| Original symptoms such as pain | ♦️May greatly decrease right after surgery or might slowly go away as the healing progresses. |
| Recovering from hospital | ♦️Remain in hospital for 4 days after surgery, you may stay longer if you have infections or other complications. |
| First month | ♦️Important to follow your doctors’ instructions: ♦️You’ll be advised to avoid spinal bending and twisting, lifting any objects heavier than around eight pounds, and strenuous physical activity |
| 5 to 9 weeks | ♦️You’ll rely on physical therapy appointments to build muscle strength, regain flexibility, and support the recovery process. ♦️Positive effects of core stabilization training on muscle strength and endurance were observed in the short term (ozden,2022) |
| 3 to 6 months | ♦️You’ll continue to regain strength and flexibility. The range of activities and exercises you can participate in will expand. |
| 6 months to 1 year | ♦️Here the vertebrae of the spine should have fused successfully ♦️You may get an x-ray to check the healing. ♦️You’ll be cleared to return to most of your normal activities, including non-extreme spinal twisting, bending, and lifting. |
| 1 year and beyond | ♦️Completely recovered, no back pain. You may have some permanent mobility restrictions at the fused level |
▶️Are there any permanent restrictions movement after spinal fusion
No, there is no lifelong ban on movement after spinal fusion. For most patients who undergo a single-level spinal fusion, mobility restrictions aren’t dramatically life-altering
The surgical procedure is carefully done and the materials used are very sturdy to withstand the stresses of walking, trunk movement and even running.
Once the spine has fully healed, some people return to sports such as running even for longer distances, with spinal fusion.
That’s not to say that everyone will be able to do it, for example if you have never done it before it’s harder to imagine doing it for the first time after surgery.
If you have multiple spinal levels fused, you are likely to experience significant mobility restrictions such as bending, twisting and flexion of the spine.
However, it is advisable before your surgery to review any potential activity limitations with your spine surgeon before a spinal fusion so you can weigh your benefits and risks.
There are some activities that may be a hindrance to your spine after surgery that you may not be able to do for some time or for ever. This will very on individual.
For example:
♦️You may not be able to perform powerlifting exercises after spinal fusion or any activity that puts extreme stresses on the spine for at least 6 months or more.
♦️You may be restricted from certain physical labour jobs such as heavy lifting, repetitive lifting, twisting, or lower back bending.
▶️Is having a spinal fusion a disability? And can you be eligible for disability benefits?
Here in the UK ,it may be considered a disability if it significantly impairs an individual’s ability to engage in substantial gainful activity
The eligibility for disability benefits is determined by the impact of the spinal fusion and any resulting limitations on an individual’s daily activities and work capacity.
Not sure about other countries but you can find out by reaching out to your state’s benefit systems.
▶️Why does my back hurt 10 years after spinal fusion?
I have seen patients come back for x-ray complaining of lower back pain after 10 years of a spinal fusion.
Most of the time when an x-ray is taken, these are some of the common findings on x-ray that may be the possible cause of pain.
🟢Adjacent segment degeneration issues may start causing pain because motion is restricted across the fusion which may lead to additional surgery in the future.
🟢Hardware damage such as screws falling out can cause symptoms to reappear.
It is true that hardware used in the operation is highly durable but after 10 years the spinal fusion may start causing you pain.
🟢Fusion failure (Pseudoarthrosis): this is when the vertebrae fail to merge into a single bone after spinal fusion, You may not experience any symptoms, but it may cause you recurring pain and neurological symptoms.
According to Tobert,2017 in a clinical review of spinal surgery fusion between 2% to 4% of people who undergone spinal fusion surgery per year experienced adjacent degenerative issues which lead to:
🟢Back pain, pain radiating from the back to the legs and feet
🟢Numbness, tingling and weakness in the legs
🟢Trouble standing and pain walking.
So, it has been established that it is normal to experience pain even after 10 years of surgery
Some studies that have done a 10 year follow up after a spine fusion had this to say.
A prospective registry of patients who had spine fusion on major thoracic scoliosis, this was established.
🟣At a 10-year follow-up showed 16.7% out 57% patients had loss of correction in their spine
🟣There was a total of 14 revisions surgeries performed in 7.5% patients.
🟣The pain was like preoperative scores and more than previously.
Newton,2020
▶️Can I go back to work after a spinal fusion surgery?
Yes, in theory you can return to any job after a fusion surgery unless your doctor has restricted you to stay off physical labour jobs such as heavy lifting, twisting and back bending.
If you think you need retraining, then you can discuss this with your manager to see how well you can be helped to resume your normal work duties.
But a spinal fusion surgery should not stop you from working unless your situation is different and you have been advised by your doctor to stop working.
A study done in Argentine of lumbosacral spinal fusion between January 2005 to August 2018 were included (Sarotto,2021)
Did a follow-up for a period of 18 to 24 months of the average age of patients which was 42:
🟣67% were able to resume the same professional activity as before the operation in the months that followed.
▶️ When can I return to sports after a spinal fusion?
Spinal fusion surgery is being increasingly performed, yet few studies have focused on return to recreational sports after surgery.
The only data identified sports such as swimming, golf and biking, there was little information on sports such as football, ice hockey and baseball.
Here are some research studies that looked at sports such as golf, swimming and biking.
A study done between 2008 to 2012 for a I year follow up of patients who had undergone spinal fusion surgery had this to say:
200 People who had spinal fusion surgery, 79% of golfers, before the surgery experienced back and leg pain significantly which made it difficult for them to play golf.
🟣But within 1 year from surgery, 65% of patients returned to practice and 52% returned to course play.
🟣Only 29% of patients stated that continued back and leg pain limited their play.
🟣25 patients (77%) were able to play the same amount of golf or more than before fusion surgery.
🟣Of those providing handicaps, 12 (80%) reported the same or an improved handicap.
Shifflett, 2017
A study done in the USA following 63 patients who had undergone spinal fusion:
🟣Of the 117 identified lumbar fusion patients, 32 patients (27%) participated in 1 of the 3 most common recreational sporting activities of golf, swimming, or biking.
Jain,2020
A study that examined patients who had undergone cervical fusion between 1982 to 2016:
🟣After spinal fusion, 80% of professional athletes were able to return to sport at approximately 9 months, with a subsequent career average of 3 years. (Watkins,2018)
In summary, Spinal fusion surgery can have good clinical outcomes in appropriately selected patients and not everyone will return to sports than before the procedure.
But at list more than 50% of golfers return to on-course play within 1 year of lumbar fusion surgery
▶️What is the life expectancy after spinal fusion especially in the elderly?
To date there are hundreds of studies dedicated to this topic and numerous publications that summarise these studies.
I have selected study syntheses that in my opinion provided better answers to this question.
A retrospective study done by Kim,2008: over a period of 10 years had this to say:
🟦The overall 10-year survival was 87.8% in patients 60 to 70 years old at surgery.
🟦And 83.8% in patients 70 to 85 years old at surgery.
The 10-year survival rate of female patients and patients who underwent fusion surgery were higher than those of male patients.
🟦The standardized mortality ratios were 0.21, 0.53, and 0.45 in patients aged 50 to 59, 60 to 69, and 70 to 85, respectively.
🟦It was also noted that after 1 year or more after surgery, the patients who underwent fusion surgery had higher survival rates than patients who underwent non fusion surgery.
Another important reason for higher survival rates was in the younger population.
Kim ,2008.
Demographic Characteristics and Cumulative 10-Year Survival in Patients Who Underwent Spine fusion Surgery(kim,2008)
Elderly patients who underwent spine fusion surgery for spinal stenosis had reduced mortality compared to the corresponding portion of the general population
We have come to the end of this article; any questions or experience let’s meet in the comments sections.
Wishing you a quick recovery!🙋
📚Source:
Willems PC, Staal JB, Walenkamp GH, de Bie RA. Spinal fusion for chronic low back pain: systematic review on the accuracy of tests for patient selection. Spine J. 2013 Feb;13(2):99-109. doi: 10.1016/j.spinee.2012.10.001. Epub 2012 Nov 3. PMID: 23127364.
Greenwood J, McGregor A, Jones F, Mullane J, Hurley M. Rehabilitation Following Lumbar Fusion Surgery: A Systematic Review and Meta-Analysis. Spine (Phila Pa 1976). 2016 Jan;41(1):E28-36. doi: 10.1097/BRS.0000000000001132. PMID: 26555833.
Abbott AD, Tyni-Lenne R, Hedlund R Early rehabilitation targeting cognition, behavior, and motor function after lumbar fusion: a randomized controlled trial. Spine 2010; 35:848–857.
Newton PO, Ohashi M, Bastrom TP, Bartley CE, Yaszay B, Marks MC, Betz R, Lenke LG, Clements D. Prospective 10-year follow-up assessment of spinal fusions for thoracic AIS: radiographic and clinical outcomes. Spine Deform. 2020 Feb;8(1):57-66. doi: 10.1007/s43390-019-00015-1. Epub 2020 Jan 8. PMID: 31925756.
Tobert DG, Antoci V, Patel SP, Saadat E, Bono CM. Adjacent Segment Disease in the Cervical and Lumbar Spine. Clin Spine Surg. 2017 Apr;30(3):94-101. doi: 10.1097/BSD.0000000000000442. PMID: 27642820.
Özden F. The Effectiveness of Physical Exercise After Lumbar Fusion Surgery: A Systematic Review and Meta-Analysis. World Neurosurg. 2022 Jul;163:e396-e412. doi: 10.1016/j.wneu.2022.03.143. Epub 2022 Apr 7. PMID: 35398574.
Kim HJ, Lee HM, Kim HS, Moon ES, Park JO, Lee KJ, Moon SH. Life expectancy after lumbar spine surgery: one- to eleven-year follow-up of 1015 patients. Spine (Phila Pa 1976). 2008 Sep 1;33(19):2116-21; discussion 2122-3. doi: 10.1097/BRS.0b013e31817e1022. PMID: 18758368.
Shifflett GD, Hellman MD, Louie PK, Mikhail C, Park KU, Phillips FM. Return to Golf After Lumbar Fusion. Sports Health. 2017 May/Jun;9(3):280-284. doi: 10.1177/1941738116680200. Epub 2016 Nov 1. PMID: 27879299; PMCID: PMC5435149.
Jain NS, Lin CC, Halim A, Knight B, Byrne CT, Alluri R, Bhatia NN, Lee YP. Return to Recreational Sport Following Lumbar Fusion. Clin Spine Surg. 2020 May;33(4):E174-E177. doi: 10.1097/BSD.0000000000000980. PMID: 32168116.
Watkins RG 4th, Chang D, Watkins RG 3rd. Return to Play After Anterior Cervical Discectomy and Fusion in Professional Athletes. Orthop J Sports Med. 2018 Jun 18;6(6):2325967118779672. doi: 10.1177/2325967118779672. PMID: 29977944; PMCID: PMC6024542.
Sarotto AJ, Besse M, Ambrosini L, Baldassarre R, Rosado J, Baigorria J. Artrodesis lumbosacra en trabajadores de la construcción. Reinserción laboral [Lumbosacral arthrodesis in construction workers. Return to work]. Medicina (B Aires). 2021;81(5):742-748. Spanish. PMID: 34633946.