Acute Phase: 1 day - 3 weeks

  • Hospital stay: 1-2 days.
  • Hospital instructions will be given for safe transfers and bed mobility.
  • Dressing change will occur at home every other day .
  • Sponge bathing (to keep incision dry) is to be performed until removal of staples (2 weeks post-op).
  • 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).
  • Incentive spirometry four times daily.
  • Continue to take prescribed pain medication and use ice as needed for pain control.
  • Do ankle pumps on an hourly basis to promote circulation.


  • Sitting (with good posture) no longer than 20 mins 3x/day, no bending, lifting, pulling, pushing, climbing, or driving.
  • NWB for 6 weeks post-operative.

Red Flags:

If you develop fever, chills, malaise, shortness of breath, excessive drainage, redness, or extreme pain and tenderness in calf region contact physician (315) 824-1250.

Subacute Phase: 3-6 weeks

  • Follow-up x-rays may be taken at 1 week and 6 weeks to demonstrate the beginning of bone healing at fusion site.
  • Lifting restrictions (10lbs).
  • Begin core stabilization exercise.
  • Begin lower extremity flexibility as indicated.
  • No power tools.

Remodeling Phase: 7-12 weeks

  • Fusion may take 6 months to 1 year to fully heal.
  • Begin WBAT gait with appropriate device wean as able .
  • Begin lumbar ROM to tolerance in all planes, slowly working mid range to end range within limits of pain.
  • Progress core stabilization.
  • Progress Lower extremity flexibility to tolerance.
  • Progress endurance exercise, treadmill walking.
  • Return to prior level of function and work related activities (pending M.D. orders and release).
  • Physical therapy will emphasize pelvic neutral, improving postural awareness, lower and upper extremity strengthening, flexibility and nerve root glides, and improving functional activities of daily living (walking, stair climbing, etc).

Return to Activity Phase: 12 weeks

  • Return to full function without restrictions as tolerated.