Cervical Posterior Fusion — Cervical Posterior Spinal Instrumented Fusion (PSIF)

Axis Spine Center · Axis Spine Physical Therapy Team

Weight-Bearing

WBAT; walking and stationary bike 2x/day from Phase 1 (10 min building to 20 min); 30+ min/day by Phase 2

Key Restrictions

1-level: no brace; 2-level: brace 4-6 wks; 3+ levels: brace 6 wks per MD; always wear brace in vehicle x 6 wks; no lifting >15 lbs x 12 wks; no impact x 12 wks; no passive cervical stretching; no overhead activities x 6 wks; no end-range rotation/SB x 6 wks; no driving until out of collar and off narcotics (4-6 wks); head of bed 30 deg x 7-10 days; report clear drainage with postural headaches immediately

Timeline & Phases

Phase 1 (0-2 wks): cervical AROM, supported isometrics, pec/thoracic stretching, scapular retraction, stationary bike/walking; Phase 2 (4-8 wks): OP strengthening/stabilization, cervical postural strengthening, UE ergometer, 30+ min walking; return-to-activity: elliptical/hiking/Pilates at 4 wks, jogging/outdoor biking/swimming at 12 wks, skiing/golf/basketball/soccer at 16-24 wks

Notes

Posterior cervical midline incision; head clamp positioning; neuromonitoring (electrode needles scalp/extremities) for all myelopathic/posterior cervical patients - source of postop bruising/soreness; bone growth stimulator (osteopenic) worn 6-12 months if issued; imaging at 6 wks for bony fusion; Axis Spine Center 08.08.21

Surgeon / Author

Axis Spine Physical Therapy Team

Published

August 2021