exercise after lumbar spinal fusion without instrumentation

[charlen]

  Hi,
  I have posted a couple of times in regards to my ruptured lumbar disc's with fragments
  floating in my spinal canal and pressing against my spinal cord along with
  severe L5 nerve root compression on the left.  I will be having a spinal fusion
  in less than 2 weeks without instrumentation using a bone graft from my
  illiac crest along with removal of the fragments, numerous bone spurs and any scar
  tissue that can be safely removed.  My question is how much exercise and at what rate (how soon post-op) does
  a regular exercise regimen should begin. by the way--this is back operation #3 for me,
  had two discectomies 10 years ago with almost total recovery of all
  my R.O.M. and my neurological symptoms from then diminished to almost non-existant.  I think
  this is an excellent recovery from 2 discectomies.  Anyways..my reason for asking
  this is that I am also an insulin dependent diabetic and my ortho surgeon
  told me that my recovery will probably be slower and he will not push for
  an aggressive rehab program till around the 3rd month which will entail intensive
  P.T. and walking.  He explained it to me this way..6-10 days in the hospital,
  walking around my hospital room day 1 1/2 to 2 days post-op, then progressing to
  walking in the hallway before I go home. Once home he wants me to be pretty
  much on bedrest for the 1st 4 weeks.  He said at home I can walk around my house
  several times a day, move my feet and legs in bed, not much sitting except to
  use the toilet and eating.  I will be wearing a hard plastic brace that is
  being specially made for me for about 3 months or longer.  After the 4 weeks
  of not doing much, I will begin walking more and more still with limited sitting.
  After the 2nd month post op I will work up 1-2 miles per day and continue to increase
  that as I progress.  Does this sound sensible?  My surgeon and my GP are concerned
  about too much irritation and infection with my diabetes even though I am good
  to tight control with my blood sugars.  They want me to take it easy and especially
  since I am not having instrumentation there is a higher risk of the fusion not healing
  or coming apart( he does not use instrumentation as he feels it sometimes causes
  more problems that it fixes plus with me being a diabetic and allergic to many
  things he does not feel using them would be wise for me.)  My reason for asking this as I thought this was a pretty
  safe standard regimen, however on another web forum for spinal disorders I was told
  that it was not enough and that I should be walking a mile to two miles a day by
  4 weeks post-op...that sounds like too much to me...thank you in advance for
  your time....Charleen
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Dear Charleen,
Every surgeon has his own particular style for mobilizing patients after a
spinal fusion procedure.  The regimen you describe sounds reasonable.  As you
know, you carry an added risk to non-fusion with the history of diabetes.
Your surgeon will probably want to err on the side of being more conservative
in mobilization to give you the best possible chance at fusion after surgery.
Good luck.