What is the usual schedule for mobilization after lumbar disc surgery with plating?

Mobilization Schedule After Lumbar Disc Surgery with Plating

Early mobilization between 24-48 hours after lumbar disc surgery with plating is recommended, with patients beginning with sitting out of bed for 30 minutes on day 0 and progressing to 6 hours per day thereafter, with walking commencing on day 1. 1

Initial Mobilization Phase (0-48 hours)

• Patients should be mobilized early (between 24-48 hours post-surgery) if there are no contraindications 1
• Day 0 (day of surgery): Sit out of bed for 30 minutes 1
• Day 1: Begin walking and progress to sitting out of bed for 6 hours per day 1
• Contraindications to early mobilization include arterial puncture for interventional procedures, unstable medical conditions, low oxygen saturation, and lower limb fracture or injury 1

Early Postoperative Phase (Days 2-14)

• Continue progressive mobilization with sitting, standing, and walking activities based on functional level 1
• Mobilization should be conducted daily, 7 days a week 1
• Patient education about mobilization goals should be provided preoperatively 1
• Avoid high-intensity exercise during this period 2

Intermediate Phase (2-6 weeks)

• Most formal rehabilitation programs begin 4-6 weeks after surgery 2
• Patients should be educated to perform their own basic rehabilitation exercises until formal rehabilitation begins 2
• Regular exercise is highly recommended for long-term pain relief and speedy recovery 3
• Early implementation of exercises (starting at 2 weeks) has been shown to result in better pain scores and functional outcomes compared to later implementation 3

Advanced Phase (6+ weeks)

• Intensive exercise programs starting 4-6 weeks post-surgery show strong evidence for improved functional status and faster return to work compared to mild exercise programs 4
• Formal spine rehabilitation with structured protocols should be fully implemented by 2-3 months postoperatively 2

Benefits of Early Mobilization

• Reduces risk of complications including respiratory decompensation, deep venous thrombosis, pulmonary embolism, and urinary tract infections 5
• Decreases length of hospital stay 5
• Improves long-term functional outcomes 3
• Prevents muscle loss and other complications associated with prolonged bed rest 1

Important Considerations

• Mobilization should be supervised by appropriately trained healthcare professionals 1
• The intensity of rehabilitation should be commensurate with anticipated benefit and tolerance 1
• There is no evidence that patients need to have their activities restricted after first-time lumbar disc surgery, and restricting activity does not reduce re-herniation rates 4
• Patient training, accurate information about the postoperative course, and proper pain management play important roles in the final outcome 6

Monitoring During Mobilization

• Early warning scoring systems can help identify patients at risk for adverse events during mobilization 1
• Patients should be assessed for appropriate and safe methods of transfer and mobilization 1
• Multidisciplinary team approach is beneficial for early mobilization protocols 1