[Postoperative management of weight bearing and rehabilitation after lumbar spinal surgery]

Orthopade. 2020 Mar;49(3):201-210. doi: 10.1007/s00132-019-03799-2.
[Article in German]

Abstract

Background: Because of the growing trend of lumbar spinal surgery, it is essential for physicians and physiotherapists to develop standardized postoperative treatment. However, currently postoperative treatment after lumbar spinal surgery is controversial.

Purpose of the study: The purpose of this review article is to make recommendations for the postoperative treatment of lumbar intervertebral disc surgery, lumbar decompression surgery and lumbar spinal fusion surgery regarding mobilization, weight bearing and rehabilitation. These recommendations are based on current evidence and experience in our institution.

Materials and methods: A selective literature research of relevant publications was conducted in Pubmed. The studies are presented in tabular form.

Results: Patient training, accurate information about the postoperative course, information about limitations and stress possibilities as well as pain management seem to have an important role in the final outcome of the operation. Ideally, these procedures should be performed preoperatively or at the latest or repeatedly from the first postoperative day after lumbar spine surgery. Physiotherapy can have a positive impact on the clinical and functional outcome after lumbar disc, decompression and fusion surgery.

Discussion: Due to the heterogeneity of the intensity, duration and form of physiotherapy or rehabilitation, which are listed as interventions in the various studies, it is only possible to draw limited conclusions about general instructions for action on "physiotherapy" after spinal surgery.

Keywords: Disk prolapse; Pain management; Physiotherapy; Surgical decompression; Vertebral column.

Publication types

  • Review

MeSH terms

  • Decompression, Surgical*
  • Humans
  • Lumbar Vertebrae
  • Lumbosacral Region
  • Postoperative Care*
  • Spinal Fusion*
  • Spinal Stenosis
  • Treatment Outcome
  • Weight-Bearing