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What are the restrictions on fusions?

SplendagrrlSSplendagrrl Posts: 108
edited 06/11/2012 - 8:54 AM in Back Surgery and Neck Surgery
I will be having a two level fusion at the end of July or first week in August. I believe it was S1 and L4-5. Anyway say the surgery is somewhat successful and I have recovered etc.. I know this stops movement in that area. What I really do not understand will be the restrictions and limitations afterwards. What kind of things can you not do because your lower spine no longer moves? Not what can't I do because of my pain, but just because of the fusion itself. Can everyone who has had one give me some input on limitations once your lower spine is fused? Are there things you just cannot do anymore? Are there limits on lifting after you heal and fuse? Can you not bend over? What about sitting? Sex? Sorry but just want to know how this will affect my life after healing. Thanks!


  • i will tell you what my consultant told me .it would take up to 3 years to recover from .the first year would he the worst .no lifting/bending/twisting.my fusion is being done to prevent any more damage and if there is any reduction to my pain then that will be a bonus {you may be different} .as a man ...sex for me has become impossible since i had my last operation and hit middle age .again for you things may be different .personally i dont think that i will ever get better and this operation will make me worse .but as a human and always hopeful and still young.ish! {45} i and my wife are hoping that it will give us some better quality time together .as i cant go on as i am ..again i dont know your personal circumstances .but i do wish you the best for you operation and i hope you have a fast healthy recovery
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
  • I had a 2 level fusion at the same levels as you are about to (L5-S1, L4-L5). It was nearly a year ago now.

    I would say to be very careful at the beginning with bending, lifting, twisting, pushing and pulling, because all of these can have a bearing on your recovery and/or pain levels.

    I would love to report now that I can do ANYTHING, but I can't. The thing is you have to consider what you could do before your surgery. I had so much back pain before that I couldn't do anything anyway - all I did was work, and my social/home life was totally non-existent. That's why I had the fusion in the end, to try and improve the quality of my life.

    I did make a very bad mistake at 6 weeks after surgery - I twisted, without thinking, when I went for my first drive. Not a good thing to do and I feel I paid the price every since! This really annoys me because until then, I was totally pain free and OFF ALL MEDS!!! I'm now back on the same medications I had before surgery - but as I said, this is probably my own fault. I'm being assessed at the moment for sacro-iliac problems, which I don't think I had before. Then again, I've read some posts on Spine Health saying they didn't have problems with this joint before they had fusion surgery either. It may be just a coincidence, or maybe I had problems before but it was never picked up, or it could be as a result of the fusion, I just don't know. Hence the investigations.

    Everyone is different of course. I've met people who have gone back into the gym, done marathons, taken up playing golf, had babies, pretty much everything they could do before, which is great. They are totally off all medications and have never felt better. Some have actually said that they have been given their life back, which is brilliant. So please don't be discouraged by everything you may read on these forums. All the people who have had successful outcomes may not visit the forum any more because they are too busy living their lives!!! However, you have to be realistic. Your back will have gone through some trauma during surgery and may not be the same again and you will have to make some allowance/adjustment if you do start to feel pain when trying different activities.

    As for me personally, there are things I cannot do any more, and there are things I can do, but not as well as before. It's taking a very long time, but I'm trying to accept my limitations. I am still in pain and have recently had steroid sacroiliac injection, but it hasn't helped so far unfortunately. I have joined a gym and am building up my 'core strength' slowly. If I try and push myself, there's really no point 'cos my back will hurt me too much and it may mean I cannot work - which for me, would be awful. I don't have a good worklife balance at the moment, but I'm trying to sort this out with the help of my Occupational Health doctor at work, who has been really supportive.

    In my case, I don't think the fusion has been 100 per cent successful, but on the other hand, if I didn't have it done one year ago, I may actually be much worse by now? Who knows. It was a chance I was prepared to take and if I really look after myself, I'm still hopeful of a successful outcome.

    Basically, the rule I go by now is: If it hurts, I don't do it!!

    Hope this all helps.
    2 x Microdiscectomy 2005 / PLIFusion 2-level 2010 / revision surgery 2011 / NEVRO Senza spinal cord stimulator implanted February 2013. I WILL NOT GIVE IN / UP !!
  • The first year while you fuse you have some restrictions. They aren't really that bad and mostly have to do with how much weight you can lift. The rest is common sense stuff. You surgeon and/or his PA should give you those.

    After the fusion is complete, for me a year, all restrictions were lifted. It was recommended that I never lift weights over my head. So if you're into weight lifting that might be a problem. Beyond that I have no restrictions. Including sex. Figured I'd add the most important one. You might have to give up hanging from the chandeliers or the trapeze versions. Other than that it's all good :-)

    You should plan on waking with a stiff back. A few basic stretches every morning to loosen it up and you're good to go. 2 levels from S1-L4. you'll lose some range of motion like touching your toes. Beyond that not really so bad. Depends on how flexible you were in the first place.

  • I'm nearly 2 years out and fusion has been a blessing for me.

    However, I cannot sit for long without pain, and the same with standing, but to a lesser degree. I spend quite a lot of time in my recliner rather than sitting in a normal chair. I have issues with the levels either side of the fusion, but these were there prior to fusion of L4-5. I may need further surgery at some time.

    The BEST thing is that I can walk without pain and enjoy life again - take the dogs out, have coffee with friends, exercise, light gardening, etc.

    It was 6 months before I started to feel normal and I was fused by then. It took another 6-8 months before I could feel extra strength in the lumbar area and able to do more activities.

    It's so important to adhere to the BLT restrictions during those first 6 months. This will be your time to concentrate on healing. There'll be lots of frustrating days and you could be tempted to do more than you should - happens to us all, and then we suffer with a pain flare, and it's back to bed. I started driving locally at about 6-8 weeks. I have some stiffness in the lumbar area and weakness in the left leg, but I can cope with that.

    Would encourage you to prepare well at home with meals and arrangements for help at home - family, friends. You'll need this for a few months and it will take the stress off you.

    My surgeon aims for 80% - 90% pain reduction and this is where I'm at. When trying any new activities, I have to think how will it affect my back.

    Hope all goes well for you.


    XLIF L2-4 20.8.15
    ALIF L4/5 2009
    Laminectomy/discectomy L4/5 2008
  • Here is my general take on your post.
    I had a 360 L4-S1 fusion on 1-20-2010. Went back to work in automotive assembly plant 6 months later. Surgeon gave me no restrictions. I was told after questioning this to just use caution, think thru tasks at work or at home, and try to use good body mechanics. I have become quite good at managing my pain levels. I still take a lot of meds, but am able to do anything I want. That being said I do not want to do any heavy lifting or bending.

    This is my answer to your specific question of
    "Not what can't I do because of my pain, but just because of the fusion itself".
    I find putting on my work boots and lacing them up to be difficult now. I have also had to developed a new way to get the paperwork done in the bathroom(if you get my meaning). I have to use a long handled brush in the shower. So I guess most of my ROM problems revolve around bending at the waist.

    As for the rest of your questions....Sitting for long periods is difficult. this really only effects how long I can ride in a car without needing to get out and stretch. I can go @ an hour at a time. Most things that I have ROM problems only needed a different approach to achieve. When I have to pick something up off the ground I hit a knee instead of bending at the waist. Sex is much the same scenario, just have to be creative, although I have not found a way to replace thrust from the hip. Since you are a lady this may be a non-issue.

    I am sure I missed some things, but I did make an attempt to give you some insight from my personal perspective. Just remember that we are all different. I wish you the best of luck this Summer.

    Life is different after back surgery.
  • Thank you everyone for your replies they have helped a lot in knowing what to expect. I guess what I was worried about was if I would ever be able to lift my grand baby again! That would be just too sad if I couldn't, but I guess I would adjust. Just sit down and have him climb in my lap. I was also worried if my back was stiff if I would ever be comfortable again just sitting on the recliner watching tv. But it seems that is only a problem in hard straight back chairs am I right?
  • Thank you everyone for your replies they have helped a lot in knowing what to expect. I guess what I was worried about was if I would ever be able to lift my grand baby again! That would be just too sad if I couldn't, but I guess I would adjust. Just sit down and have him climb in my lap. I was also worried if my back was stiff if I would ever be comfortable again just sitting on the recliner watching tv. But it seems that is only a problem in hard straight back chairs am I right?
  • It's mainly hard backed chairs where I have a problem sitting for longer periods, such as my computer chair, which is a good ergonomic one. With the recliner, I can have my legs out and a pillow behind my back. It's the sitting still that's the main problem and I have to wriggle a lot.

    I often stand at the computer, like I am now, and in the early recovery days, I put a couple of phone books under the keyboard so that I didn't have to bend over.

    With your grandbaby, definitely sit down and have him climb on your lap.

    Once I learned to make adjustments in how I did things, it was ok - I stopped thinking of how I used to do whatever it was.


    XLIF L2-4 20.8.15
    ALIF L4/5 2009
    Laminectomy/discectomy L4/5 2008
  • Splendagirl:

    I have been fused from L1 to S1. I don't bend, I squat or kneel, keeping a straight back. I keep my hips VERY flexible since that is the only place I have flexibility. I do hamstring stretches so my back will not be too tight. I swim a lot and that really helps to be weightless and works all the muscle groups. I walk. I can't sit except in my recliner.

    Sex has helped keep my hips flexible. Be sure you get your doctors ok or are sufficiently healed and out of pain.

    There are limits on reaching and lifting. Use common sense and good lifting techniques. Respect the limit the doctor gives you.

    I do PT on my own regularly to keep my core strong and also do weights for my upper body. I was quite active before all this and am trying to remain so with my limitations. I was actually able to ride my commute bike, more upright than my road bike, for the first time this weekend. Only 5 miles but hey it was glorious. Little steps. We have to let go of the past.

    I can't touch my toes but thats overrated. you learn to live with what you CAN do!!

    Good luck and if you have any other questions please ask.


    Spinal stenosis, spondolysis, spondolythesis, L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion with instrumentation and bone graft from hip, L1/S1 fusion with replacement disc put in and a nice bolt from my spine to my pelvis; PT, accupuncture, prolotherapy, many cortisone injections, 4 rhizotomies. Currently on tramadol.

    L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion, L5/S1 fusion w/ disc replacement, left and right SI joints fused.
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