Acute Phase: 1 day - 1 week post-op

  • Hospital stay 0-1 night.
  • Restrictions: No pushing, pulling, bending, or lifting, no driving, no sitting more than 20 minutes at a time.
  • Walking is encouraged as much as tolerated.
  • Sponge bathe only until staples are removed at 2 weeks post-op.
  • Incentive spirometry four times daily.
  • TED stocking to be worn most of the time. Only removed 2-3 times per day for ½ hour to wash lower extremity (until 1st post-op appointment).
  • Do ankle pumps on an hourly basis to promote circulation.
  • Finish all antibiotics and continue use of pain medications (as needed and only as prescribed).
  • Call your primary doctor about resuming your pre-operative medications including blood thinners.
  • First physician post-op appointment at 2 weeks.

Please call if any of the following occur:

  • High fever and chills.
  • Redness, bleeding, drainage, or swelling of the wound.
  • Severe sudden pain that persists.
  • Severe pain in legs and/or shortness of breath.

Subacute Phase: 1 week - 8 weeks post-op

  • Begin physical therapy pending physician orders.
  • Gradually restore functional range of motion (mid range only).
  • No flexion beyond neutral until 6 weeks post-op.
  • Progress lumbar stabilization exercise program as tolerated.
  • Lower extremity flexibility exercises where indicated.
  • Incorporate knee extension and dorsiflexion exercises to avoid neural adherence.
  • Postural and body mechanics education and correction.
  • Lower extremity strengthening .
  • Continue endurance exercises with emphasis on walking to tolerance.

Return to Activity Phase: 8+ weeks

  • Restore full lumbar range of motion in all planes.
  • Progress all exercises as needed to allow for return to full function.
  • Instruct in home exercise program for self-management.

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