Jesse L.
Even, MD
Board Certified Spine Surgeon
WWW.TMISportsmed.com
Lumbar Fusion
REHABILITATION PROTOCOL
Keith Meister,
Phase I:MDProtection Phase/Immediate Motion (0 – 12 Weeks post-op)
Sports Medicine / post-op:
0-12 Weeks
Arthroscopy Head Team
q No outpatient PT or the first 12 weeks unless otherwise specified by physician
Physician q Gradual return to ADL’s at home with Home Health PT
q Will see MD at 3 weeks, 3 months, 6 months, and 12 months post op
12-14 Weeks post-op:
q Recumbent bike no resistance: avoid excessive lumbar flexion or extension
q Manage pain and swelling/modalities prn
q Monitor scar and tissue mobilization
q Begin neural glides/mobilizations. Do not reproduce symptoms
q Light resistance upper/lower extremity exercises: 0-5 lbs.
§ Lumbopelvic stabilization in neutral spine
§ Focus on addressing baseline weakness (i.e footdrop)
§ Posture training
q Home program review/posture education
q Avoid excessive lumbar flexion and extension
q Okay to start PROM or stretching
q Initiate neutral spine core stability training on treatment table: hook lying TA training,
diaphragmatic breathing, lumbar multifidi training, etc.
q Soft tissue mobility prn
q Increase activity tolerance
Phase II: Intermediate Phase (14 -18 Weeks post-op)
14-16 Weeks post-op:
q Continue recumbent bike, may progress to upright bike
q Manage pain and swelling, modalities prn
q Progress UE/LE strengthening: increase strength and activity tolerance
q Continue neutral spine core stability training on mat. Okay to initiate sitting and standing
neutral spine stability training.
q Continue soft tissue mobility
q May begin grade I-II joint mobilizations on spinal segments. No joint mobilizations
within 2 segments adjacent to fusion.
Home to the Texas Rangers
MD Ph 817-419-0303 3533 Matlock Road, Arlington, Texas, 76015 MD FAX 817-468-5963
PT Ph 972-623-2629 PT FAX 972-623-2661
16-18 Weeks post-op:
q Continue upright bike, may progress to elliptical, treadmill walking
q Progress UE/LE strengthening
q Initiate saggital plane core stability training. Gradually progress flexion/extension.
q Continue soft tissue mobility, modalities, as needed
q Continue joint mobilizations on spinal segments. No joint mobilizations within 2
segments adjacent to fusion
Phase III: Advanced Strengthening Phase (18 - 24 Weeks post-op)
18-22 Weeks post-op:
q Continue cardio equipment as tolerated
q Introduce core training in transverse and frontal planes progressing to multi planar
q Un-restricted upper/lower body strengthening.
22-24 Weeks post-op:
q Continue with all ROM, flexibility, stretching, and strengthening exercises
q Initiate plyometric program
24-26 Weeks post-op:
q Continue with all ROM, flexibility, stretching, strengthening and plyometric exercises
q Progress slowly to straight line jogging
q Initiate interval sport program if applicable after consultation with physician
Phase IV: Return to Activity Phase (26 - 36 weeks post-op)
q Continue with established strength and flexibility programs
q Continue to comply to interval sport program with gradual return to recreation/sport
q Criteria for return to play:
§ Satisfactory ROM, Strength, and Clinical Exam
§ Satisfactory completion of interval sport program
§ Physician approval
Home to the Texas Rangers
MD Ph 817-419-0303 3533 Matlock Road, Arlington, Texas, 76015 MD FAX 817-468-5963
PT Ph 972-623-2629 PT FAX 972-623-2661
