Spinal Fusion: What Are (Permanent) Movement Restrictions?

You’ve just had (or are about to have) spinal fusion (lumbar, thoracic) or neck (cervical), and you’re wondering whether movement is forbidden in the weeks following the operation?

Are any movements banned for life? When should rehabilitation begin?

My answers as a physiotherapist, reinforced by my research into the scientific studies published on the subject!

♻️ Last update: February 10, 2025.
👩‍⚖️ Declaration of financial interests: none directly related to the subject. My complete declaration of interest is in the legal notice section.
Written by Nelly Darbois, physiotherapist and scientific editor

What type of spinal fusion am I talking about here?

Here, I’ll be looking at the after-effects of the most frequently performed types of spinal fusion, performed on the vertebrae.

Lumbar fusion: at the level of the lumbar vertebrae, at the bottom of the spine. And lumbosacral fusion, when the material goes all the way down to the sacrum.

Cervical fusion: at the level of the cervical vertebrae, in the middle of the spinal column.

Less common thoracic fusion: involving the thoracic vertebrae (also known as the dorsal vertebrae).

These surgical fusion can be performed for a variety of reasons.

No matter why your surgeon has suggested the operation: osteoarthritis, pain for no reason or in connection with a herniated disc, complex vertebral fracture, vertebral instability, spondylolisthesis, spinal stenosis, etc., the precautions to be taken in the aftermath are the same.

What precautions should be taken in the weeks following spinal fusion?

Spinal fusion is a major operation. Bones and other tissues have been damaged in order to place the equipment (plate, screws, rods), and need time to consolidate and heal.

Your surgeon has given you post-operative instructions

Your surgeon will normally have given you verbal and written precautions to limit pain and promote tissue healing for 1 to 3 months after the operation.

Depending on the surgical team you’ve come across and the specific operation performed, these instructions can be very different.

Some teams will, for example, 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.

Or “forbid” you to pick something up off the ground while leaning forward, or to garden leaning very far forward, right up to the control rado.

Or “ban” yourself from driving for at least 3 weeks, to limit the back and neck rotations required when driving. Or avoid prolonged static sitting. (See: when to drive after an operation or fracture).

Others, on the other hand, will not give any particular precautionary instructions, even in the first few weeks after the operation.

In this case, it means that your only limit is the pain or discomfort you feel during or after the movements you make and the positions you adopt!

Do you find these instructions too restrictive or lax?

You may be among those who find the instructions you’ve been given too restrictive or, on the contrary, too lax.

In this case, you can discuss the matter with your physiotherapist or general practitioner, to see how things can be readjusted. I’ve often e-mailed a surgeon to review the contraindications given.

Examples of resumption of movement and physiotherapy after cervical fusion

Here’s the procotole followed by professional athletes undergoing cervical fusion surgery (Watkins 2018):

• wear a cervical collar for 2 weeks to limit excessive movements;
• permission to walk and ride an elliptical without hands or a recumbent bike from the day after the operation (if there is no major pain and the follow-up X-ray is OK);
• physiotherapy began 6 weeks after the operation. Begins with trunk stabilization exercises.

Movement and rehabilitation after lumbar fusion

A Belgian research team 🇧🇪 asked a number of healthcare professionals about the best way to manage a single- or two-level lumbar fusion: physiotherapists, neurosurgeons, psychologists, nurses, general practitioners and an epidemiologist.

Here are their results:

In particular, the experts recommend :

• not to wear a lumbar belt or corset after the operation;
• encourage the resumption of rapid physical activity in the days following the operation: walking, stairs, transfers, picking things up off the floor, doing everyday tasks at home, cycling at a leisurely pace;
• resume more strenuous physical activity approximately 3 months after fusion, subject to medical approval.

Source: Bogaert 2023

Are any movements prohibited for life after spinal fusion?

No, there is no lifelong ban on movement after spinal fusion.

The material used is very sturdy. It’s made to withstand the stresses of walking, trunk movement and even running.

Some people return to running, and even marathons, with lumbar or cervical fusion.

That’s not to say that everyone will be able to do it: for example, if you’ve never done it before, it’s harder to imagine doing it for the first time after fusion surgery.

Figures on returning to sport after fusion surgery

Here are some figures on sport after fusion surgery.

In the United States 🇺🇸 (Jain 2020), 117 people who had undergone lumbar fusion were followed up. The average age was 63.

100% of people who played golf, swam or cycled before the operation were able to resume. Within 3 to 9 months of surgery.

All had significantly less pain than before the operation, but did not practice their sport significantly more.

Both male and female golfers were more restricted in their movement and this altered their dexterity and frap strength.

Another publication in the USA 🇺🇸 (Watkins 2018) looked at return to sport in professional athletes who had had cervical fusion.

80% of athletes were able to return to top-level sport after an average of 9 months, with a subsequent career average of 3 years.

The sports concerned were soccer, American soccer, basketball, baseball and ice hockey.

Can I go back to work after an fusion surgery?

Yes, in theory you can return to any job after fusion surgery, even physically demanding ones.

However, depending on how you feel, it may be necessary to adapt your workstation. And for some people, to consider retraining.

You can discuss this with your physiotherapist or GP, who may have known you for a long time, in addition to your occupational physician.

Here are some figures on the return to work after different types of fusion surgery.

🇦🇷 In Argentina (Sarotto 2021), 139 people working in the construction sector who had undergone lumbar or lumbosacral fusion for degenerative low back pain were followed up. The average age was 42.

67% were able to resume the same professional activity as before the operation in the months that followed.

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That’s all I wanted to say on the subject! Any questions or comments? See you in comments!