Back pain is a symptom, not a specific disease. It afflicts almost everyone at some point in their lives and is second only to the common cold as the cause of lost days of work and visits to a doctor's office or emergency room. "The back is a complex structure with many processes that can break down and cause pain," says Dr. Praveen Kadimcherla, an orthopedic spine surgeon at Atlantic Spine Center. "Often no specific cause can be pinpointed and the pain will abate without treatment or with conservative measures like rest, physical therapy, anti-inflammatory medication, or the injection of a cortisone-like medication into the lower spine. Surgery is advised only when the cause of the pain can be precisely identified and generally only for those who do not respond to other treatments, whose symptoms get worse, or who experience progressive neurological decline."
Spinal fusion is a surgical procedure that corrects problems with the small bones of the spine (vertebrae). It eliminates movement between vertebrae by fusing together the painful vertebrae so they heal into a single, solid bone.
"Spinal fusion is an option when motion is the source of pain," says Dr. Kadimcherla. "Preventing the movement of affected vertebrae prevents the friction that causes pain and also reduces pressure on surrounding nerves." Spinal fusion can relieve the symptoms of several conditions, including degenerative disk disease, herniated lumbar disk (in which a bulging disk pinches the nerve), spondylolisthesis (in which one vertebra slips over the bone below it), and stenosis (a narrowing of the open spaces in the spine, which puts pressure on the spinal cord and the nerves that travel through it). "For people who have suffered for years with back pain that hasn't responded to conservative treatment, spinal fusion can enable them to resume favorite activities and vastly improve their quality of life."
There are several different ways spinal fusion may be performed, depending on the patient's age, overall health, and the specific condition to be corrected. Some patients are candidates for a minimally invasive procedure that reduces recovery time but for many, traditional or "open" spinal fusion is the best option and they must understand what to expect following surgery to ensure the speediest recovery and most successful results.
Full recovery from traditional spinal fusion takes three to six months. "Understanding the fusion process makes clear how recovery proceeds and why the three-month benchmark is an important juncture," says Dr. Kadimcherla. "In the three months following surgery, the fused bone mass is becoming established. Until that point, the fusion is fragile and too much movement or stress can cause damage. Patients are advised to rest and to avoid bending, twisting, and lifting. By twelve months, the fusion has set and gentle exercise becomes an important factor in further healing, both to strengthen the back and to restore muscle tone."
Dr. Kadimcherla offers these suggestions for What to Expect Three Months After Surgery:
- Post-surgical pain will have tapered off and you will most likely be off pain medication, making driving possible, as long as your doctor approves.
- Don't be afraid to move – carefully! After three months of coddling your back, it's understandable to be nervous about movement but now is the time to start a very gradual reconditioning program that includes stretching, strengthening, and aerobic exercise.
- Physical therapy isn't optional! You may already be working with physical therapist. As you start feeling better, it's important to continue to with the guidance of a professional who will ensure that you proceed appropriately.
- Accept help. At this point, you should be more comfortable with daily activities but continue to avoid bending, twisting, and lifting anything heavy.
- Follow general guidelines for good health. Eat a well-balanced diet with a wide variety of whole grains and plant-based foods; focus on foods that are rich in essential vitamins and minerals, especially calcium. Get plenty of sleep. Don't smoke.
- Don't be impatient! Recognize that healing is a gradual process and rushing things can backfire.
"The three-month point after spinal fusion surgery is generally an important milestone," says Dr. Kadimcherla. "Primary healing is complete, the fusion is established, and it is now time to rebuild strength, regain energy, resume regular activities, and begin to enjoy the improved quality of life you've worked hard for."
For further information about reasons for fusion, how the fusion process works to stabilize the spine and how bone healing occurs around the fusion, watch our detailed educational video located on our YouTube channel