All indications are that the more time people are off from work before spinal fusion, the worse their outcomes after surgery. Patients are being encouraged to remain as active as possible up to the point of surgery including staying at work.
These recommendations come from a series of studies confirming the link between preoperative work status and outcomes after either spinal fusion or disc replacement for disc degeneration. Improvement in pain and function are greater in fusion or disc replacement patients who are off work the shortest amount of time.
The longer patients are off work before surgery, the worse their function is and the smaller their improvement. In one study from the Texas Back Institute Research Foundation, the cutoff period of time was 13 weeks. Patients who were off work for less than 13 weeks had better results compared with those who were off work longer. Patients off work for more than 13 weeks still showed improvement, just not as much as the group with the shorter off-work duration.
As a result, surgeons at that facility are telling patients who are candidates for spinal fusion to stay on the job as long as possible. It could help improve your results after surgery. They are also looking at other options. For example, maybe there’s a different way to approach postoperative rehab that could lead to better results for patients who have been off work for too long.
It’s been suggested that a few extra weeks of rehab may be needed after surgery to improve results in patients who have been inactive for so long. A similar study assessing the optimal number of weeks in rehab might help in planning the most appropriate postoperative rehab. Talk with your surgeon about this decision. Knowing your health history and general condition, he or she may have some additional thoughts or factors to consider in making this decision.