In Canada we don’t have many patients who had a lumbar fusion to treat low-back pain. Most of my
patients with lumbar fusion come from the States. Lumbar fusion is a type of surgery that removes
the disc between two or more vertebrae, and fuse the bones. So there is no more movement
between these vertebrae. Or another way to fuse is to use plates, and screws and fixate
the bones. The thinking behind this is that if the bones don’t move anymore there will be no pain.
In some cases, fusion is necessary because the surgeon removed parts of the vertebrae
to alleviate a disc herniation, a spinal stenosis,
or a tumour. The removal of bone causes instability, so the surgeon must fuse the bones.
After a lumbar fusion, the person loses the ability to move that segment of their spine.
When they come to me, they want to know what kind of exercises they can do after a lumbar fusion.
So, let’s talk about workouts after a lumbar fusion
First, it is important to get clearance from their surgeon if they can start doing exercises.
Usually, the first 6 months after the lumbar fusion surgery the only exercise the person can
do is walking, and they should walk 3 to 5 times a day. During this period they should not twist,
bend their trunk or lift heavy weight. But after 6 months, the bones are
permanently fused, and the person is allowed to start building muscles and stretching.
So, what kind of exercises are recommended? Swimming, biking, walking, and elliptical are
excellent. These are cardio and strengthening exercises. They should practice them every day,
and for the rest of their lives. They can also do pilates and yoga.
They should build the core muscles around their spine, that includes the quadratus lumborum,
the paraspinals, the abdominals, gluteus, and stretch the IT band, hamstrings and quadriceps.
Now, what happens if the person does not do these exercises after a lumbar fusion?
Before I continue, please remember that this video is for educational purposes
only and is not intended to replace medical advice,
and if you had a lumbar fusion or is thinking of having one, please talk to your doctor.
If there is an emergency please go to the nearest emergency department or call an ambulance
Well, that is the main problem. The person may think that the fusion will take care of their
pain, and they become sedentary, deconditioned and gain weight. This is really harmful to
their bones, muscles, but also to the pain system. They can develop central sensitization
which is abnormal transmission of pain signals in the neural pathways.
If this happens, the volume of pain can be increased, and instead of feeling a tiny
little pain, they feel a huge, excruciating pain. That is because central sensitization
amplifies the pain intensity in our brain. I have another video about central sensitization.
So, exercises are crucial to good results from lumbar fusion.
But you might be thinking. I had surgery because I had pain, and I never exercised before,
and I hate exercise. I thought I would be free from doing exercises, and now you are telling
me that I will have to exercise, and exercise intensely every day for the rest of my life?
Yes, that is what the surgeons will tell you. So, my suggestion to you is this:
Why don’t you exercise intensively before you have lumbar fusion? Why don’t you give it a try,
do everything as if you had had a lumbar fusion? I know a lot of people who have done this,
and they end up feeling so much better that they cancel the surgery.
This is called pre-habilitation or prehab. There is evidence from scientific studies that
doing exercises prior to surgery for cancer improves the results of the cancer surgery.
If you work hard, and exercise every day you will also be retraining your pain system,
reducing central sensitization, reducing chronic inflammation, improving your mood,
sleeping better, and improving your self-esteem. You will have to do exercises anyways after the
lumbar fusion. So, why not do them before the surgery?
Did you know that if you decide to have lumbar fusion, the joints below and above the lumbar
fusion will have to work hard to compensate for the lack of movement of the fused bones. And
they may develop pain and arthritis, and then you may need surgery on the levels below and above.
That is why a lot of people have one, two, three, four,
multiple spine surgeries to treat lumbar pain. We call this failed back surgery syndrome.
Failed because the person continues having pain, or worsening pain after back surgery.
Well, leave your comments below, and send this video to someone who is thinking of having
a lumbar fusion, maybe they can start prehab and improve their symptoms.
Thanks for watching. Bye