Postoperative rehabilitation program after lumbar fusion internal fixation

  Rehabilitation goals: 1.Guiding patients on postoperative contraindicated movements and restricted movements; 2.Guiding patients on spinal training methods to prevent re-injury and low back pain caused by weakness; 3.Guiding patients on functional activities: the correct way to get in and out of bed, safe transfer methods, walking; 4.Guiding patients on nerve loosening to prevent adhesions and reduce neurological symptoms.  Postoperative contraindications: 1.For 3 months, it is contraindicated to bend forward, extend backward, bend sideways and rotate excessively the lumbar region; 2.For 1 month, it is contraindicated to move heavy objects over 2-3 kg; picking up objects should be squatted and picked up; 3.It is contraindicated to exercise that causes neurological symptoms.  Postoperative pain management: Pain management: 1, drugs; 2, recommended pain relief lying position; 3, nerve relaxation; 4, spinal median posture; Phase I: (1-2 days after surgery) 1, bed transfer training Safe turning: rolling method, keep the shoulders, hips, feet in a line overall turning, the waist can not be rotated.  Get in and out of bed: abdominal muscles tighten and maintain, use hands and elbows to support the body, keep the upper body not to bend sideways.  2, the maintenance of core strength (1) bend knees supine, knee flexion 70 ° ~ 90 ° feet flat on the bed, the small abdominal region back (navel to the spine), maintain and slow breathing, maintain 5 minutes per hour and gradually increase.  (2) Lie prone or on the side and place the thumb or index finger next to the lumbar spinous process and instruct the patient to “bulge” the muscle against the finger. Once learned, encourage practice throughout the day.  3. Nerve Release (Professional Physiotherapist) Phase 2 (3 days-6 weeks post-op) 1. Correct wearing of lumbar girth; 2. Correct transfer: from lying to sitting to walking, maintaining a neutral spinal posture.  3.Lumbar spine stability training: activating core stability through joint movement of upper and lower limbs, the occurrence of pain is strictly prohibited during movement, which can be completed from simple to difficult, ten times per hour.  4.This stage is prone to spasm, persistent or new-onset radiculopathy at the surgical site, which can be loosened by the nerve of self.  Phase 3 (6-12 weeks) Goal: Remove waist circumference and gradually return to normal life.  1.Self-neural relaxation; 2.Further strength training; 3.Maintain median spine position in life .