How long will it be before I can go back to work?
What does the recovery process look like?
What, if anything, could go wrong at this stage?
Recovery time is an important consideration for many patients considering spinal fusion. This blog examines the answers to those common questions. But if you’re doing your homework on spinal fusion, you may already know that the long-term results of fusion are less than ideal.1 That means you should also be investigating other alternatives—and the recovery times associated with them—so we’ll take a look at some of those, too.
Spinal Fusion Surgery: Recovery Time
To set the stage for a discussion about recovery, you need to understand how spinal fusion works. Your spine is a stack of bony vertebrae all connected together. Discs provide cushioning and movement between each vertebral body, and facet joints at each level of your spine control excess movement. During fusion, your surgeon removes the disc material and all or part of the facet joints, packs the space with bone graft, and then inserts spacers, screws, and rods into the bones to temporarily hold everything in place. Eventually, the bone graft fuses, the body heals, and what were once two separate vertebrae are now joined as one solid mass of bone.
It sounds fairly straightforward, and, for most patients, it is. But there are sometimes cases where healing doesn’t go as planned. During the recovery months, surgeons keep a close eye on the progression of bone growth—the bone needs to grow across the gap where the disc used to be to create that “one solid mass of bone.” Before that happens, the hardware is not fully stable.
For most patients, growth simply takes time. For others, however, the bone never heals completely adequately; it’s a condition we call pseudarthrosis, or nonfusion. Because the bone never fully welds together, motion may continue across the area, causing pain and loosening of the hardware. Normally, the time it takes for bones to fully fuse is approximately four to five months, but it can take up to a year. If it still hasn’t happened after eight months, the condition is referred to as a “delayed union” or “delayed healing”; it becomes pseudarthrosis if healing is still incomplete after one year. The treatment for pseudarthrosis is a second attempt at fusion by adding some additional bone grafting.
Would you rather avoid fusion? Download this free brochure about a new procedure, BalancedBack® Total Joint Replacement, that will restore your spinal health faster.
Spinal Fusion Surgery Recovery Timeline
Timetables vary by patient, especially as it pertains to when they can go back to work. It largely depends on what type of work they do, whether they have a primarily manual job or an office job. Surgeons like to see some form of bone growing across the gap before they allow patients to do activities without restrictions. In general, the recovery timetable looks like this:
Day of/day after surgery—patients get out of bed, start moving around, and sitting up.
Four to six weeks—only walking and sitting. No major exercises.
Six weeks to five months—walking, driving, possibly returning to work in an office setting.
Five to six months—Manual workers return to work.
A Spinal Fusion Alternative: Total Joint Replacement Recovery
If you’re hesitant about fusion and looking for another option, consider BalancedBack® total joint replacement. It addresses the same root causes of pain as fusion, but without fusing bones together at the expense of a joint. Instead, the BalancedBack® device replaces the functions of both the damaged disc and the facets, essentially giving you a new joint that allows you to keep moving.
After BalancedBack® surgery, your soft tissues have to recover from the incision, but there’s no need to wait for bone to span a gap. After removing the disc and facets, surgeons insert the BalancedBack® device neatly inside the disc space, with no screws protruding—a factor that helps reduce postoperative pain. The replacement joint then carries the mechanical load of your movements in the same way your original facet joints did.
Because the device is intended to act as a joint, BalancedBack® patients recover faster. Why? Think of it this way: The fusion device is intended to create something rigid; too much movement early on weakens the screws and stresses the growing bone. In contrast, the BalancedBack® device moves with you, which means your movements automatically put less stress on it. You’ll heal faster as a result. And the device is stable as soon as it’s put in, which means you can start resuming your regular activities sooner than you could with fusion.
Take a look at the BalancedBack® recovery timetable below. Again, it varies somewhat from patient to patient, but it does represent a typical progression.
BalancedBack® Recovery Timeline
Day of/day after surgery—patients get out of bed, move around, and sit up.
Day 3/day 4—patients begin a walking program. Walking is the best type of exercise after disc replacement surgery because it puts low stress on the back.
Two weeks after surgery—patients can get in a swimming pool, do aerobic activities, use light hand weights, or do a stationary bike. At this point, most patients can do a small amount of stretching (about 25 to 30 degrees of motion)—enough to bend forward slightly as needed, take a shower, etc. The majority of patients can also drive short distances at this point.
Six weeks after surgery—Patients can usually bend further—45 to 50 degrees—as needed, and can continue to do the activities listed above.
Three months after surgery—On average, most patients have no further restrictions on their activities three months after their procedure.
This timetable denotes the average recovery timeline, but note that approximately 40% of patients undergoing lumbar fusion surgery rate themselves as symptomatically unchanged or worse following surgery.2
Would you like to learn more about BalancedBack®?
If you’re in search of an alternative that not only helps you avoid a lengthy spinal fusion recovery time but also keeps you moving more naturally after surgery, why not speak with a member of our clinical team? We’ll answer your questions about total joint replacement and help you determine if it might be a good fit for you.
1Mannion, A. F., Brox, J. I., & Fairbank, J. C. (2016). Consensus at last! Long-term results of all randomized controlled trials show that fusion is no better than non-operative care in improving pain and disability in chronic low back pain. The Spine Journal, 16(5), 588-590.
2Stromqvist B., Fritzell P., Hagg O., Jonsson, B. One-year report from the Swedish National Spine Register. Swedish Society of Spinal Surgeons. Acta Orthop Suppl. 2005; 76:1-24.