Postoperative Care after ETDIF

After a minimally invasive ETDIF surgery, patients are usually kept in the recovery area for several hours for observation. During this time, the surgeon will consult with the patient and review how the surgery went.

After a period of observation, the patient will be asked to stand up and walk around before being discharged and allowed to return home.

Because patients usually return home on the day of surgery it is termed an outpatient surgery. For an endoscopic-assisted ETDIF, or for patients with other medical conditions, a one or two-night hospital stay may be required.

See Outpatient Lumbar Fusion

Pain Management

Oral pain medications, such as opioids and sometimes a muscle relaxant, are usually prescribed to manage pain for the time period following the surgery, usually about 1 to 2 weeks.

See Opioid Medication Potential Risks and Complications

After the initial period, postoperative pain can usually be managed with use of an over-the-counter medication, such as acetaminophen (the main ingredient in Tylenol). Patients are cautioned to first check the label of other medications for acetaminophen, as many types of opioids and other medications may already contain acetaminophen.

Any type of anti-inflammatory medication (called NSAIDs) should be avoided, as anti-inflammatory drugs impede the bone growth required for the fusion to successfully form. Commonly available NSAIDs include ibuprofen (e.g. Advil) and naproxen (e.g. Aleve).

See Back Pain Medication Overview: Understanding Medication for Back Pain Relief

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Activity Restrictions

Any activity recommendations will be specific for the individual patient. In general, here are several typical recommendations after an ETDIF:

  • Rest and gentle stretching for the first several days, with short walks—as tolerated—allowed the first week. After the first week, slowly increasing the duration of walks is recommended.
  • Avoid bending, twisting, or lifting anything weighing more than 10 pounds for the first several weeks.
  • No driving or operating machinery while on opioid or other strong pain medication or muscle relaxants, which is usually for 1 to 2 weeks after the surgery.
  • Anyone with an office job will typically return to work about 1 to 4 weeks after surgery; anyone with more manual work may needs several months before returning to work.
  • Considerable improvement is usually seen after the first few weeks, and physical therapy should generally begin at this point.

See Guide to Physical Therapy After Spinal Fusion

While many activities are allowed as tolerated by the patient, as a general rule there are a few activities that should be avoided until there is confirmation that the fusion is solid, which is usually about 6 to 12 months after the surgery. For example, vigorous sports, such as tennis or basketball, and some sports with a lot of twisting and force on the lower back, such as golf, should be avoided.

See Spinal Fusion Surgery Recovery: Three Months and After