Lumbar Spinal Fusion — Lumbar Fusion (PSIF / ALIF / LLIF / TLIF)

Axis Spine Center · Axis Spine Physical Therapy Team

Weight-Bearing

WBAT from POD 1; walking progression; driving at 2-4 wks when off narcotics and no leg weakness

Key Restrictions

No flexion or extension/rotation beyond neutral; no lifting >15 lbs x 12 wks; no impact activities x 12 wks; no sitting >30 min; brace if >2 level fusion or osteoporotic; bone growth stimulator 6-12 months if prescribed; ALIF: expect ecchymosis/edema into groin (especially men); LLIF: expect anterior thigh numbness and hip flexor/quad weakness on approach side (psoas/lumbosacral plexus irritation, temporary)

Timeline & Phases

2 phases: Phase 1 (0-2 wks, wound healing and protection: TA/glute isometrics, balance, walking 10-15 min 1-2x/day), Phase 2 (4-12 wks, functional strength/OP PT: balance, gait training, TA bracing progression to bridges, bird dogs, mini squats, step ups); no lifting >15 lbs or impact activities until 12 wks

Notes

Covers all fusion approaches (PSIF/ALIF/LLIF/TLIF) with approach-specific considerations; detailed wound care per incision type (Dermabond vs staples vs nylon sutures); robotic navigation noted; vertebral augmentation (cement) and iliac fixation variants described; fusion with osteotomy; revision PSIF considerations

Surgeon / Author

Axis Spine Physical Therapy Team

Published

August 2021