Recovery after lumbar spinal fusion: stages from ward to return to activity

The dates come from a Royal Devon physiotherapy leaflet and an RNOH patient guide, which differ in places because hospitals and operations differ. Treat them as ranges and follow the leaflet your own team gives you.

A fusion has two jobs to do at once: you get your strength and walking back, while the bones slowly join. That second job is invisible, which is why rules about bending, twisting and lifting last longer than the wound pain.

Royal Devon says your spine is stable after the operation and that movement needed for your daily routine is encouraged, but avoid excessively stretching the spine. It describes rolling like a log in bed to avoid twisting, and a cough pad held over the incision if coughing hurts, particularly after an abdominal approach.

Hull says keep the wound dry until clips or stitches are removed, shower rather than bathe at first, and report leaking, redness or swelling. Pain and discomfort are normal and medicines can help you keep moving.

Royal Devon says you can start driving when you feel comfortable doing an emergency stop, often not until 4 weeks, and advises breaking up long journeys. RNOH says you may start driving after speaking to your consultant at your post-operative clinic review. GOV.UK says you must tell DVLA if you are still unable to drive 3 months after an operation, and your insurer may set terms too.

Work depends on the job. RNOH says extensive surgery may need as much as six months away; a desk-based role may be possible sooner, but that is something to agree with your surgeon.

• Build sitting tolerance in small steps, starting with short periods, and walk between them.

• Avoid slumped postures such as legs outstretched in the bath.

• Keep the amount you carry light; a bag of shopping is roughly the limit in the first weeks.

Walking is the main exercise at first, three to four times a day at a comfortable pace according to Royal Devon. Swimming and a stationary bike can start at about 2 months, and running, jumping and contact sports wait until your surgeon says so. RNOH advises avoiding bending the hips more than 90 degrees, twisting and lifting more than 1kg in each hand early on.

Expect a clinic review and, possibly, a rehabilitation programme organised through the ward physiotherapists, which Royal Devon says is unlikely to start before 6 weeks. Scans may be used to check that the bones are joining. Ask what the schedule is for your hospital.

• New numbness or weakness in the legs, or a change in bladder or bowel function: contact your team urgently, as Hull advises.

• Numbness around the genitals or bottom, or being unable to pass urine: A&E or 999.

• Fluid or bleeding outside the dressing, or spreading redness or fever: contact the hospital.

• Calf pain or swelling, chest pain or breathlessness: 999.