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Aaron WeyMD, FAAOS, FACSAdult and Pediatric Spine Surgery
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Spine · Post-op rehabilitation protocol

Lumbar Laminectomy or Diskectomy

Rehabilitation after lumbar laminectomy or diskectomy: early walking and posture work, core strengthening from month one, full activity at six months.

This is the rehabilitation plan I ask your physical therapist to follow after this operation. Bring it to your first therapy visit. It is a framework, not a prescription: your therapist adjusts the pace to how you are healing, and anything we discussed in the office takes precedence over what is printed here. If something on this page does not match what we talked about, ask me.

Physical therapist: please send progress notes to the office at (201) 836-1663 and call with any question about the plan.

Days 1–30

Exercises

  • TLSO – Per surgeon
    • Should never be required, but may be worn for comfort
  • Ambulation progression as tolerated
    • Use assistive device as needed (FWW, Cane)
    • Progress to treadmill when independent
  • Bed mobility / Positioning
    • Log rolling, instruct in proper transfers (oob to chair, car)
    • Place pillow between knees when sidelying
    • Place pillow under knees when supine
  • Ankle pumps, glut sets, quad sets
  • Pelvic tilts
  • Short arc quads
  • Deep breathing exercises
  • Posture education – Use lumbar roll when sitting
    • Maintain neutral posture
  • Diskectomy – AVOID SITTING, avoid long car rides x 2 weeks
    • NO bending, twisting or lifting over 10 pounds
  • Laminectomy – May sit, bend and twist without limitations
    • Lift as pain permits
  • TENS / Ice to assist with pain relief

Goals

  • Pain control
  • Ambulate without assistive device up to 1 mile per day

Months 1–3

Exercises

  • Continue appropriate previous exercises
  • Wall squats
  • Lumbar stabilization exercises
  • Push-up progression – Wall to table to chair
  • Abdominal crunches beginning at 6 wks post-op – NO Sit-ups
  • Treadmill – Walking progression program
  • Elliptical trainer
  • Stairmaster
  • Pool therapy
  • LE stretches – HS, quads, gastroc/soleus, hip flexors
  • Back stretches – Knee to chest, supine rotation, piriformis, prone extension
  • May begin lifting and bending using proper biomechanics

Goals

  • Walk 2 miles at 15 min/mile pace
  • Pain-free ADLs

Months 3–6

Exercises

  • Continue appropriate previous exercises
  • Work hardening / job-specific exercises
  • Push-up progression – Knees to regular
  • Sit-up progression
  • Treadmill – Running progression program

Goals

  • Pass a return-to-sport / fitness test at 6 months post-op
  • Resume all activities at 6 months post-op

Abbreviations

AROM / AAROM / PROM: active / active-assisted / passive range of motion. ROM: range of motion. ER / IR: external / internal rotation. ABD / ADD: abduction / adduction. FLEX / EXT: flexion / extension. WBAT / PWB / TTWB / NWB: weight bearing as tolerated / partial / toe-touch / non-weight bearing. SLR: straight leg raise. HS: hamstrings. ITB: iliotibial band. UE / LE: upper / lower extremity. UBE: upper body ergometer (arm bike). BAPS: balance board. BFR: blood flow restriction training. PREs: progressive resistance exercises. D/C: discontinue. prn: as needed. POD: post-operative day. TENS: transcutaneous electrical nerve stimulation. ADLs: activities of daily living.

Source

Adapted from William Beaumont Army Medical Center, Physical Therapy Section, "LaminectomyFusion WB08", Revised August 2008, published by William Beaumont Army Medical Center (a work of the U.S. Government in the public domain). One source sheet covers Lumbar Laminectomy / Diskectomy and Lumbar Fusion; the Fusion restriction line is in lumbar-fusion.md. Original: LaminectomyFusion WB08.pdf. Army-specific wording in the original (MOS, APFT) was replaced with civilian equivalents.

This protocol is general guidance for the rehabilitation team and does not replace the specific plan, restrictions and follow-up we set together. Your own situation may differ: if anything here does not match what we talked about, what we talked about wins, so please ask me.