Anterior Lumbar Interbody Fusion

A Patient’s Guide to Anterior Lumbar Interbody Fusion


Anterior Lumbar Interbody Fusion

Anterior lumbar interbody fusion (ALIF) is a procedure used to treat problems such as disc degeneration, spine instability, and deformities in the curve of the spine. In this procedure, the surgeon works on the spine from the front (anterior) and removes a spinal disc in the lower (lumbar) spine. The surgeon inserts a bone graft into the space between the two vertebrae where the disc was removed (the interbody space). The goal of the procedure is to stimulate the vertebrae to grow together into one solid bone (known as fusion). Fusion creates a rigid and immovable column of bone in the problem section of the spine. This type of procedure is used to try and reduce back pain and other symptoms.

This guide will help you understand

  • what surgeons hope to achieve
  • what happens during surgery
  • what to expect as you recover


Anterior Lumbar Interbody Fusion

What parts of the spine and low back are involved?

Anterior Lumbar Interbody Fusion

Anterior Lumbar Interbody Fusion

ALIF surgery is performed through the front (anterior). The structures in this area include the anterior longitudinal ligament, the vertebral bodies, and the intervertebral discs. The anterior longitudinal ligament attaches along the front of the spinal column. The vertebral bodies are the large blocks of bone that make up the front section of each vertebra.

The intervertebral discs are the cushions between each pair of vertebrae.

Related Document: A Patient’s Guide to Lumbar Spine Anatomy


What do surgeons hope to achieve?

This procedure is often used to stop symptoms from lumbar disc disease. Discs degenerate, or wear out, as a natural part of aging and also from stress and strain on the back. Over time, the disc begins to collapse, and the space decreases between the vertebrae.

Related Document: A Patient’s Guide to Lumbar Dengenerative Disc Disease

When this happens, the openings around the spinal nerves (the neural foramina) narrow and may put pressure on the nerves. The long ligaments in the spine slacken due to the collapse in vertebral height. These ligaments may buckle and put pressure on the spinal nerves.

View animation of degeneration

Also, the outer rings of the disc, the annulus, weaken and develop small cracks. Tears in the outer annulus are painful because these tissues are rich with pain sensors. The nucleus in the center of the disc may press on the weakened annulus and actually squeeze out of the annulus (herniate). Inflammation from the nucleus as it escapes the annulus also causes pain. The nucleus normally does not come in contact with the body’s blood supply. However, a tear in the annulus puts the nucleus at risk for contacting this blood supply. When the nucleus herniates into the torn annulus, the nucleus and blood supply meet, causing a reaction of the chemicals inside the nucleus. This produces inflammation and pain.

Anterior Lumbar Interbody Fusion

If the nucleus presses against the spinal nerves, symptoms of pain, numbness, and weakness may occur where the nerve travels. Pressure on the spinal nerves inside the spinal canal can also produce problems with the bowels and bladder, requiring emergency surgery.

Discectomy is the removal of the disc (and any fragments) between the vertebrae that are to be fused. Taking out the painful disc is intended to alleviate symptoms. It also provides room for placing the bone graft that will allow the two vertebrae to fuse together. The medical term for fusion is arthrodesis.

Once the disc is removed, the surgeon spreads the bones of the spine apart slightly to make more room for the bone graft. The bone graft separates and holds the vertebrae apart. Enlarging the space between the vertebrae widens the opening of the neural foramina, taking pressure off the spinal nerves that pass through these openings. Also, the long ligaments that run up and down inside the spinal canal are pulled taut so they don’t buckle into the spinal canal.

View animation of spreading vertebrae apart

View animation of graft fusion

Anterior Lumbar Interbody Fusion

If the fusion is successful, the vertebrae that are fused together no longer move against one another. Instead, they move together as one unit. This helps relieve the mechanical pain, which occurs in the moving parts of the back. Fusion also prevents additional wear and tear on the spinal segment that was fused. By fusing the bones together, surgeons hope to reduce future problems at the spinal segment.


How will I prepare for surgery?

The decision to proceed with surgery must be made jointly by you and your surgeon. You should understand as much about the procedure as possible. If you have concerns or questions, you should talk to your surgeon.

Once you decide on surgery, your surgeon may suggest a complete physical examination by your regular doctor. This exam helps ensure that you are in the best possible condition to undergo the operation.

On the day of your surgery, you will probably be admitted to the hospital early in the morning. You shouldn’t eat or drink anything after midnight the night before.

Surgical Procedure

What happens during the operation?

Patients are given a general anesthesia to put them to sleep during most spine surgeries. As you sleep, your breathing may be assisted with a ventilator. A ventilator is a device that controls and monitors the flow of air to the lungs.

The patient is positioned on his or her back with a pad placed under the low back. An incision is made through one side of the abdomen. The large blood vessels that lie in front of the spine are gently moved aside. Retractors are used to gently separate and hold the soft tissues apart so the surgeon has room to work.

Anterior Lumbar Interbody Fusion

The surgeon inserts a needle into the disc. By taking an X-ray with the needle in place, the correct disc is identified. Forceps are used to open the front of the disc. Next, a tool is attached to the vertebrae to spread them apart. This makes it easier for the surgeon to see between the two vertebrae. A small cutting tool (a burr) is used to carefully remove the front half of the disc. A special surgical microscope may be used to help the surgeon see while removing pieces of disc material near the back of the disc space.

The surgeon shaves a layer of bone off the flat surfaces of the two vertebrae. This causes the surfaces to bleed. Bleeding stimulates the bone graft to heal and join the bones together.

Anterior Lumbar Interbody Fusion

The surgeon measures the depth and height between the two vertebrae. Making a separate incision, the surgeon takes a section of bone from the top of the pelvis to use as a graft. The graft is measured to fit snugly in the space where the disc was taken out. The surgeon uses a traction device to spread the two vertebrae apart, and the graft is tamped into place.

Traction is released. Then the surgeon tests the graft by bending and turning the spine to make sure the graft is in the right spot and is locked in place. Another X-ray may be taken to double check the location and fit of the graft.

Anterior Lumbar Interbody Fusion

Most surgeons apply some form of metal hardware, called instrumentation, to prevent movement between the vertebrae. Instrumentation protects the graft so it can heal better and faster. One option involves screwing a strap of metal across the front surface of the spine over the area where the graft rests. A second method involves additional surgery through the low back, either on the same day or during a later surgery. In this operation, metal plates and screws are applied through the back of the spine, locking the two vertebrae and preventing them from moving.

Related Document: A Patient’s Guide to Posterior Lumbar Fusion

A drainage tube may be placed in the wound. The muscles and soft tissues are then put back in place. The skin is stitched together. The surgeon may place you in a rigid brace that straps across the chest, pelvis, and low back to support the spine while it heals.


What might go wrong?

As with all major surgical procedures, complications can occur. Some of the most common complications following ALIF include

  • problems with anesthesia
  • thrombophlebitis
  • infection
  • nerve damage
  • blood vessel damage
  • problems with the graft or hardware
  • nonunion
  • ongoing pain

This is not intended to be a complete list of possible complications.

Problems with Anesthesia

Problems can arise when the anesthesia given during surgery causes a reaction with other drugs the patient is taking. In rare cases, a patient may have problems with the anesthesia itself. In addition, anesthesia can affect lung function because the lungs don’t expand as well while a person is under anesthesia. Be sure to discuss the risks and your concerns with your anesthesiologist.

Thrombophlebitis (Blood Clots)

View animation of pulmonary embolism

Thrombophlebitis, sometimes called deep venous thrombosis (DVT), can occur after any operation. It occurs when the blood in the large veins of the leg forms blood clots. This may cause the leg to swell and become warm to the touch and painful. If the blood clots in the veins break apart, they can travel to the lung, where they lodge in the capillaries and cut off the blood supply to a portion of the lung. This is called a pulmonary embolism. (Pulmonary means lung, and embolism refers to a fragment of something traveling through the vascular system.) Most surgeons take preventing DVT very seriously. There are many ways to reduce the risk of DVT, but probably the most effective is getting you moving as soon as possible. Two other commonly used preventative measures include

  • pressure stockings to keep the blood in the legs moving
  • medications that thin the blood and prevent blood clots from forming


Infection following spine surgery is rare but can be a very serious complication. Some infections may show up early, even before you leave the hospital. Infections on the skin’s surface usually go away with antibiotics. Deeper infections that spread into the bones and soft tissues of the spine are harder to treat. They may require additional surgery to treat the infected portion of the spine.

Nerve Damage

Anterior Lumbar Interbody Fusion

Any surgery that is done near the spinal canal can potentially cause injury to the spinal cord or spinal nerves. Injury can occur from bumping or cutting the nerve tissue with a surgical instrument, from swelling around the nerve, or from the formation of scar tissue. An injury to the spinal cord or spinal nerves can cause muscle weakness and a loss of sensation to the areas supplied by the nerve.

Blood Vessel Damage

The abdominal aorta is the largest artery in the body. This major artery and the large veins that accompany it pass in front of the spine and split to go into each leg. The surgeon has to move these vessels aside to perform the anterior interbody procedure. The vessels can be injured, causing internal bleeding.

Problems with the Graft or Hardware

Fusion surgery requires bone to be grafted into the spinal column. The graft is commonly taken from the top rim of the pelvis. There is a risk of having pain, infection, or weakness in the area where the graft is taken.

After the graft is placed, the surgeon checks the position of the graft before completing the surgery. However, the graft may shift slightly soon after surgery to the point that it is no longer able to hold the spine stable. If the graft migrates out of position, it can cause injury to the nearby tissues. A second surgery may be needed to align or replace the graft and to apply metal plates and screws to hold it firmly in place.

Hardware can also cause problems. Screws or pins may loosen and irritate the nearby soft tissues. Also, the metal plates can break. The surgeon may suggest another operation either to take out the hardware or to add more hardware to solve the problem.


Anterior Lumbar Interbody Fusion

Sometimes the bones do not fuse as planned. This is called a nonunion, or pseudarthrosis. (The term pseudarthrosis means false joint.) When more than one level of the spine is fused at one time, there is a greater chance that nonunion will occur. (Fusion of more than one level means two or more consecutive discs are removed and replaced with bone graft.) If the joint motion from a nonunion continues to cause pain, the patient may need a second operation.

In the second procedure, the surgeon usually adds more bone graft. Metal plates and screws may also be added to rigidly secure the bones so they will fuse together.

Ongoing Pain

ALIF is a complex surgery. Not all patients get complete pain relief with this procedure. As with any surgery, patients should expect some pain afterward. If the pain continues or becomes unbearable, talk to your surgeon about treatments that can help control your pain.

After Surgery

What happens after surgery?

Patients are sometimes placed in a rigid body brace after surgery. This may not be necessary if the surgeon attached metal hardware to the spine during the surgery.

Patients usually stay in the hospital after surgery for up to one week. During this time, patients work daily with a physical therapist. The therapist demonstrates safe ways to move, dress, and do activities without putting extra strain on the back. The therapist may recommend that the patient use a walker for the first day or two. Before going home, patients are shown ways to help control pain and avoid problems.

Patients are able to return home when their medical condition is stable. However, they are usually required to keep their activities to a minimum in order to give the graft time to heal. Patients should avoid activities that cause the spine to bend back for at least six weeks. Patients are also cautioned against bending, lifting, twisting, driving, and prolonged sitting for up to six weeks. Outpatient physical therapy is usually started a minimum of six weeks after the date of surgery.


What should I expect as I recover?

Rehabilitation after ALIF can be a slow process. Many surgeons prescribe outpatient physical therapy beginning a minimum of six weeks after surgery. This delay is needed to make sure the graft has time to fuse. You will probably need to attend therapy sessions for two to three months. You should expect full recovery to take up to eight months. However, therapy can usually progress faster in patients who had fusion with instrumentation.

At first, treatments are used to help control pain and inflammation. Ice and electrical stimulation are commonly used to help with these goals. Your therapist may also use massage and other hands-on treatments to ease muscle spasm and pain.

Active treatments are slowly added. These include exercises for improving heart and lung function. Short, slow walks are generally safe to start with. Swimming and use of a stair-climbing machine are helpful in the later phases of treatment. Therapists also teach specific exercises to help tone and control the muscles that stabilize the low back.

Your therapist also works with you on how to move and do activities. This form of treatment, called body mechanics, is used to help you develop new movement habits. This training helps you keep your back in safe positions as you go about your work and daily activities. Training includes positions you use when sitting, lying, standing, and walking. You’ll also work on safe body mechanics with lifting, carrying, pushing, and pulling.

As your condition improves, the therapist tailors your program to prepare you to go back to work. Some patients are not able to go back to a previous job that requires strenuous tasks. Your therapist may suggest changes in job tasks that enable you to go back to your previous job or to do alternate forms of work. You’ll learn to do these tasks in new ways that keep your back safe and free of strain.

Before your therapy sessions end, your therapist will teach you ways to avoid future problems.

Lumbar Degenerative Disc Disease

A Patient’s Guide to Lumbar Degenerative Disc Disease


Lumbar Degenerative Disc Disease

The intervertebral discs in the lower spine are commonly blamed for low back pain. Yet low back pain has many possible causes, and doctors aren’t always certain why symptoms occur.

During an office visit for low back pain, your doctor may describe how changes in the discs can lead to back pain. When talking about these changes, your doctor may use the terms degeneration or degenerative disc disease. Although the parts of the spine do change with time and in some sense degenerate, this does not mean the spine is deteriorating and that you are headed for future pain and problems. These terms are simply a starting point for describing what occurs in the spine over time, and how the changes may explain the symptoms people feel.

This guide will help you understand

  • how degenerative disc disease develops
  • how doctors diagnose the condition
  • what treatment options are available


Lumbar Degenerative Disc Disease

What parts of the spine are involved?

The human spine is made up of 24 spinal bones, called vertebrae. Vertebrae are stacked on top of one another to form the spinal column. The spinal column gives the body its form. It is the body’s main upright support. The section of the spine in the lower back is known as the lumbar spine.

Lumbar Degenerative Disc Disease

An intervertebral disc sits between each pair of vertebrae. The intervertebral disc is made of connective tissue. Connective tissue is the material that holds the living cells of the body together. Most connective tissue is made of fibers of a material called collagen. These fibers help the disc withstand tension and pressure.

The disc normally works like a shock absorber. It protects the spine against the daily pull of gravity. It also protects the spine during strenuous activities

Lumbar Degenerative Disc Disease

that put strong force on the spine, such as jumping, running, and lifting.

An intervertebral disc is made of two parts. The center, called the nucleus, is spongy providing most of the disc’s ability to absorb shock. It is held in place by the annulus, a series of strong ligament rings surrounding it. Ligaments are connective tissues that attach bones to other bones.

Lumbar Degenerative Disc Disease

Between the vertebrae of each spinal segment are two facet joints. The facet joints are located on the back of the spinal column. There are two facet joints between each pair of vertebrae, one on each side of the spine. A facet joint is made of small, bony knobs that line up along the back of the spine. Where these knobs meet, they form a joint that connects the two vertebrae. The alignment of the facet joints of the lumbar spine allows freedom of movement as you bend forward and back.

Related Document: A Patient’s Guide to Lumbar Spine Anatomy


Why do I have this problem?

Our intervertebral discs change with age, much like our hair turns gray. Conditions such as a major back injury or fracture can affect how the spine works, making the changes happen even faster. Daily wear and tear and certain types of vibration can also speed up degeneration in the spine. In addition, strong evidence suggests that smoking speeds up degeneration of the spine. Scientists have also found links among family members, showing that genetics play a role in how fast these changes occur.

Lumbar Degenerative Disc Disease

Disc degeneration follows a predictable pattern. First, the nucleus in the center of the disc begins to lose its ability to absorb water. The disc becomes dehydrated. Then the nucleus becomes thick and fibrous, so that it looks much the same as the annulus. As a result, the nucleus isn’t able to absorb shock as well. Routine stress and strain begin to take a toll on the structures of the spine. Tears form around the annulus. The disc weakens. It starts to collapse, and the bones of the spine compress.

View animation of degeneration

Related Document: A Patient’s Guide to Low Back Pain

This degeneration does not always mean the disc becomes a source of pain. In fact, X-rays and MRI scans show that people with severe disc degeneration don’t always feel pain.

Lumbar Degenerative Disc Disease

Pain caused by degenerative disc disease is mainly mechanical pain, meaning it comes from the parts of the spine that move during activity: the discs, ligaments, and facet joints. Movement within the weakened structures of the spine causes them to become irritated and painful.


What does the condition feel like?

Pain in the center of the low back is often the first symptom patients feel. It usually starts to affect patients in their twenties and thirties. Pain tends to worsen after heavy physical activity or staying in one posture for a long time. The back may also begin to feel stiff. Resting the back eases pain. At first, symptoms only last a few days.

Lumbar Degenerative Disc Disease

This type of back pain often comes and goes over the years. Doctors call this recurring back pain. Each time it strikes, the pain may seem worse than the time before. Eventually the pain may spread into the buttocks or thighs, and it may take longer for the pain to subside.


How do doctors diagnose the problem?

Diagnosis begins with a complete history and physical exam. Your doctor will ask questions about your symptoms and how your problem is affecting your daily activities. Your doctor will also want to know what positions or activities make your symptoms worse or better.

Then the doctor does a physical examination by checking your posture and the amount of movement in your low back. Your doctor checks to see which back movements cause pain or other symptoms. Your skin sensation, muscle strength, and reflexes are also tested.

Doctors rely on the history and physical exam to determine which treatments will help the most. X-rays are rarely ordered on the first doctor visit for this problem. This is because over 30 percent of low back X-rays show abnormalities from degeneration, even in people who aren’t having symptoms.

However, if symptoms are severe and aren’t going away, the doctor may order an X-ray. The test can show if one or more discs has started to collapse. It can also show if there are bone spurs in the vertebrae and facet joints. Bone spurs are small points of bone that form with degeneration.

When more information is needed, your doctor may order a magnetic resonance imaging (MRI) scan. The MRI machine uses magnetic waves rather than X-rays to show the soft tissues of the body. It is helpful for showing if the tissues in the disc are able to absorb water and whether there are cracks inside the disc. It can also show if there are problems in other soft tissues, such as the spinal nerves.

Discography can help with the diagnosis. This is a specialized X-ray test in which dye is injected into one or more discs. The dye is seen on X-ray and can give some information about the health of the disc or discs. This test may be done when the surgeon is considering surgery, since it can help determine which disc is causing the symptoms.


What treatment options are available?

Nonsurgical Treatment

Whenever possible, doctors prefer treatment other than surgery. The first goal of nonsurgical treatment is to ease pain and other symptoms so the patient can resume normal activities as soon as possible.

Doctors rarely prescribe bed rest for patients with degenerative disc problems. Instead, patients are encouraged to do their normal activities using pain as a gauge for how much is too much. If symptoms are severe, a maximum of two days of bed rest may be prescribed.

Back braces are sometimes prescribed. Keeping the moving parts of the low back still can help calm mechanical pain. When a doctor issues a brace, he or she normally asks that the patient only wear it for two to four days. This lessens the chance that the trunk muscles will shrink (atrophy) from relying on the belt.

Patients may also be prescribed medication to help them gain control of their symptoms so they can resume normal activity swiftly.

Lumbar Degenerative Disc Disease

If symptoms continue to limit a person’s ability to function normally, the doctor may suggest an epidural steroid injection (ESI). Steroids are powerful anti-inflammatories, meaning they help reduce pain and swelling. In an ESI, medication is injected into the space around the lumbar nerve roots. This area is called the epidural space. Some doctors inject only a steroid. Most doctors, however, combine a steroid with a long-lasting numbing medication. Generally, an ESI is given only when other treatments aren’t working. But ESIs are not always successful in relieving pain. If they do work, they often only provide temporary relief.

In addition, patients often work with a physical therapist. After evaluating a patient’s condition, the therapist can assign positions and exercises to ease symptoms. The therapist can design an exercise program to improve flexibility of tight muscles, to strengthen the back and abdominal muscles, and to help a patient move safely and with less pain.


People with degenerative disc problems tend to gradually improve over time. Most do not need surgery. In fact, only one to three percent of patients with degenerative disc problems typically require surgery.

Doctors prefer to try nonsurgical treatment for a minimum of three months before considering surgery. If, after this period, nonsurgical treatment hasn’t improved symptoms, the doctor may recommend surgery. The main types of surgery for degenerative disc problems include

  • lumbar laminectomy
  • discectomy
  • fusion

Lumbar Degenerative Disc Disease

Lumbar Laminectomy

The lamina forms a roof-like structure over the back of the spinal column. When the nerves in the spinal canal are squeezed by a degenerated disc or by bone spurs pushing into the canal, a laminectomy removes most, or all of the lamina to release pressure on the spinal nerves.

Related Document: A Patient’s Guide to Lumbar Laminectomy


Lumbar Degenerative Disc Disease

Surgery to take out part or all of a problem disc in the low back is called discectomy. Discectomy is done when the degenerated disc has ruptured (herniated) into the spinal canal, putting pressure on the spinal nerves. Surgeons commonly perform this operation through an incision in the low back. Before the disc material can be removed, the surgeon must first remove part of the lamina. Generally, only a small piece of the lamina is chipped away to expose the problem disc. This is called laminotomy. It usually creates enough room for the surgeon to remove the disc. If more room is needed, the surgeon may need to take out a larger section of the lamina by doing a laminectomy (described above).

Many surgeons now do minimally invasive surgeries that require only small incisions in the low back. These procedures are used to remove damaged portions of the problem disc. Advocates believe that this type of surgery is easier to perform. They also believe it prevents scarring around the nerves and joints and helps patients recover more quickly. Minimally invasive surgeries include percutaneous lumbar discectomy, laser discectomy, and microdiscectomy.

Related Document: A Patient’s Guide to Lumbar Discectomy


Fusion surgery joins two or more bones into one solid bone. This prevents the bones and joints from moving. The procedure is sometimes done with a discectomy. Mechanical pain is eased because the fusion holds the moving parts steady, so they can’t cause irritation and inflammation.

The main types of fusion for degenerative disc problems include

  • anterior lumbar interbody fusion
  • posterior lumbar fusion
  • combined fusion

Anterior Lumbar Interbody Fusion

Lumbar Degenerative Disc Disease

Anterior lumbar interbody fusion surgery is done through the abdomen, allowing the surgeon to work on the anterior (front) of the lumbar spine. Removing the disc (discectomy) leaves a space between the pair of vertebrae. This interbody space is filled with a bone graft. One method is to take a graft from the pelvic bone and tamp it into place. Another method involves inserting two hollow titanium screws packed with bone, called fusion cages, into the place where the disc was taken out. The bone graft inside the cages fuses with the adjacent vertebrae, forming one solid bone.

Related Document: A Patient’s Guide to Anterior Lumbar Fusion with Cages

Posterior Lumbar Fusion

Lumbar Degenerative Disc Disease

A posterior lumbar fusion is done though an incision in the back. In this procedure, the surgeon lays small grafts of bone over the problem vertebrae. Most surgeons will also apply metal plates and screws to hold the vertebrae in place while they heal. This protects the graft so it can heal better and faster.

Related Document: A Patient’s Guide to Posterior Lumbar Fusion

Combined Fusion

Lumbar Degenerative Disc Disease

A combined fusion involves fusing the anterior (front) and posterior (back) surfaces of the problem vertebrae. By locking the vertebrae from the front and back, some surgeons believe the graft stays solid and is prevented from collapsing. Results do show improved fusion of the graft, though patients seem to fare equally well with other methods of fusion.


What should I expect as I recover?

Nonsurgical Rehabilitation

Your doctor may recommend that you work with a physical therapist a few times each week for four to six weeks. In some cases, patients may need a few additional weeks of care.

The first goal of treatment is to control symptoms. Your therapist will work with you to find positions and movements that ease pain. The therapist may use heat, cold, ultrasound, and electrical stimulation to calm pain and muscle spasm.

The therapist may perform hands-on treatments such as massage and specialized forms of soft-tissue mobilization. These can help a patient begin moving with less pain and greater ease. Spinal manipulation provides short-term relief of degenerative disc symptoms. Commonly thought of as an adjustment, spinal manipulation helps reset the sensitivity of the spinal nerves and muscles, easing pain and improving mobility. It involves a high-impulse stretch of the spinal joints and is characterized by the sound of popping as the stretch is done. It doesn’t provide effective long-term help when used routinely for chronic conditions.

Traction is also a common treatment for degenerative disc problems. Traction gently stretches the low back joints and muscles. Patients are also shown stretches to help them move easier and with less pain.

As you recover, you will gradually advance in a series of strengthening exercises for the abdominal and low back muscles. Working these core muscles helps patients move more easily and lessens the chances of future pain and problems.

A primary purpose of therapy is to help you learn how to take care of your symptoms and prevent future problems. You’ll be given a home program of exercises to continue improving flexibility, posture, endurance, and low back and abdominal strength. The therapist will also discuss strategies you can use if your symptoms flare up.

After Surgery

Rehabilitation after surgery is more complex. Some patients leave the hospital shortly after surgery. However, some surgeries require patients to stay in the hospital for a few days. Patients who stay in the hospital may visit with a physical therapist in the hospital room soon after surgery. The treatment sessions help patients learn to move and do routine activities without putting extra strain on their backs.

During recovery from surgery, patients should follow their surgeon’s instructions about wearing a back brace or support belt. They should be cautious about overdoing activities in the first few weeks after surgery.

Many surgical patients need physical therapy outside of the hospital. Patients who’ve had lumbar fusion surgery normally need to wait up to three months before beginning a rehabilitation program. They typically need to attend therapy sessions for eight to 12 weeks and should expect full recovery to take up to six months.