The extended healing period required after lumbar spinal fusion surgery makes postoperative care especially important. While spinal fusion surgery has a high success rate for stabilizing 2 or more adjacent vertebrae and enabling a return to previous normal activity levels, the recovery time can vary based on many factors. These factors include the extent of the surgery, other medical conditions, and how closely the care instructions are followed.
Spinal Fusion Recovery Time
Most people are able to return home from the hospital about 2 to 4 days after lumbar spinal fusion surgery (if there are other people at home). Driving may be resumed a couple weeks after that if off opioid medications. It typically takes about 4 to 6 weeks to return to an office or sedentary job, but it can take 3 months or longer to return to activities that are more physical.
Despite the name of the surgery, the spine is not actually fused during a lumbar spinal fusion procedure. Instead, during the surgery a bone graft or substitute is placed in the spine that facilitates bone growth between the adjacent vertebrae to eventually form one bone, a process that usually takes about 3 to 6 months. The new bone will immobilize the spine at that segment. Screws, cages, plates, and rods may be implanted during surgery to stabilize the area while the bone heals and becomes solid. Some patients also wear a brace during recovery that limits motion.
The bone continues to mature and solidify over 12 to 18 months after the surgery. Many people with a single-level fusion are able to return to all activities—even vigorous ones such as weightlifting or construction work—about 6 months after surgery.
Factors That Can Slow Down Recovery Time
While it typically takes 3 to 6 months for adjacent vertebrae to fuse into one solid bone after surgery, the healing and fusion process may take longer in some patients due to:
- Smoking or other nicotine products (which contain toxins that hamper bone growth)
- Obesity and osteoporosis
- Certain chronic illnesses, such as diabetes
- Long-standing use of opioids before surgery
- Prednisone medication
Other factors can also slow down recovery. For example, engaging in higher risk activities (such as bending, lifting, or twisting) during the early part of recovery may result in a setback or require a second surgery.
Planning Ahead for Spinal Fusion
Concerns about pain control after a lumbar spinal fusion are common. Talking with the surgeon beforehand about pain relief options helps to set realistic expectations. If patients are on chronic opioid medication for 3 months before surgery, getting adequate pain control early after surgery is very difficult. Obtaining refills for medications containing oxycodone or morphine is often more time consuming than in the past, so checking ahead of time with the surgeon about the refill process can help avoid problems.
Preparing the home in advance also makes a smooth recovery more likely:
- Keep everyday items easily accessible. By keeping common items in easy-to-reach spots, bending and reaching are more easily avoided.
- Plan ahead on meals. To minimize standing and moving around the kitchen to prepare meals, stock up on microwaveable meals or cook and freeze food for later use.
- Ask for assistance. Arranging for someone to assist with heavier chores, such as laundry, may be necessary.
It is advised to also ask the surgeon for ideas about preparing for a return home after fusion surgery, such as whether the patient will be able to use stairs at first.