In addition to stretching and strengthening exercises, regular aerobic conditioning 9-12 weeks after lumbar fusion surgery is also important to help the fusion set up well. Regular aerobic exercise, even if it is just walking at a brisk pace for at least twenty minutes, will increase blood flow and oxygen. It will also burn excess calories, thus maintaining weight and preventing added stress on the back structures and surgical site.
Several exercises can provide conditioning. The key is start slowly with shorter intervals of exercise and increase duration to 30 minutes a day, in total, as long as pain is not experienced. Low impact exercises include:
- Brisk walking. See Exercise Walking for Better Back Health
- Exercising using equipment available in most gyms or for purchase for the home, such as stationary bikes, elliptical trainers, and stair climbers. See Home Exercise Equipment for Low Impact Aerobic Exercise
Not all exercise is suitable, however. Higher impact exercise that has abrupt stops, starts, and changes in direction can put a fusion that is still healing at risk. This includes exercises such as:
- Jogging or running
- Some forms of dance and aerobics
- Contact sports like basketball or football
None of these types of activities should be undertaken until a patient has been given approval by their surgeon. Finally, whatever exercise is chosen, always stop if there is any shortness of breath, chest pain, or dizziness. All these indicate overexertion that could overstress the back and rest of the body.
Avoiding activity after fusion surgery will do more harm than good for patients. Although doctors will have different opinions about the kind and intensity of post-operative activity and exercise recommended, most types of fusion will show better outcomes if an exercise regime is in place. Checking with the surgeon performing the fusion both before and after surgery will ensure that patients get the right advice for their specific situation.
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Besides the above activities it is critical that patients who have a history of smoking do not use nicotine postoperatively. Nicotine kills the osteoblasts that grow bone (bone growing cells) and the postoperative results of patients who go back to smoking are much worse than of those who remain off of nicotine.
Although remaining nicotine-free for the first three months after surgery is the most critical, smoking even after a solid fusion is achieved has been well correlated to chronic low back pain.