Because of less invasive techniques and ERAS protocols our patients can recover faster, experience less pain, and return to normal activity sooner.  Many patients — especially those undergoing a single-level lumbar fusion — may have surgery in an ambulatory surgery center where they can go home the same day.

 

What Is ERAS?

 

Enhanced Recovery After Surgery (ERAS) is a comprehensive, evidence-based approach designed to:

• Minimize opioid use, while actually improving pain control

• Encourage early mobility

• Shorten hospital stay and overall recovery time

ERAS combines optimized anesthesia, minimally invasive techniques, multimodal pain management, early nutrition, and early mobilization to promote faster, safer recovery.

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Same-Day Lumbar Fusion

 

Thanks to advancements in surgical technique, anesthesia, and postoperative protocols:

• Many one-level lumbar fusions can be safely performed in an ambulatory surgery center

• Recovery in your own home often improves comfort and reduces infection risk

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Not all patients are candidates for outpatient fusion. Your surgeon will help you decide.

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If You Stay Overnight

 

Some patients — including those with multi-level fusions or certain medical conditions — may stay in the hospital 1-3 days for monitoring, pain control, physical therapy, and wound drains if needed.

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Primary goals during early recovery:

 

• Protect the wound and fusion

• Control pain

• Gradually increase mobility

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Activity Guidelines

 

• Walk several times daily - Usually the best activity for recovery.

• Avoid bending, lifting, and twisting (BLT)

• Avoid lifting more than 5–10 pounds (about a gallon of milk)

• Use proper body mechanics

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Pain Management

 

With ERAS protocols, pain control typically includes:

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• Scheduled non-opioid medications like acetaminophen, Toradol, and a lidocaine drip

• Short-term opioid use if needed (Not typically more than one week)

• Ice therapy

• Muscle relaxants when appropriate

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Our goal is to minimize opioid use after surgery to reduce common side effects such as constipation, urinary retention, nausea, and cognitive fog. This will lower the risk of secondary complications, and promote a faster, safer recovery.

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Weeks 0-3

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• Manage pain with as little narcotic as possible

• Protect the wound by covering as needed.

• Protect the fusion by avoiding lifting, bending or twisting (BLTs)

• Mobilize safely (with walker if needed).  Often home health therapy will be arranged to help. 

• Ice low back

• Some residual nerve pain or numbness is common and should subside

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Weeks 3–12

 

• ​Transition to outpatient physical therapy (if needed)

• Advance activity restrictions and daily activities

• Nerves are still healing

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Therapy focuses on:

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• Core stabilization and postural training

• Safe movement patterns

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Months 3–6 and Beyond

 

• ​Early bone healing begins in the first few months

• Solid fusion typically takes 6–12 months

• Activity is gradually increased as healing progresses

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Most patients notice meaningful improvement in pain and function within 2–3 months.

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Driving & Work

 

• Driving is allowed once you are off narcotic pain medication and cleared by surgeon (usually 2-3 weeks).

• Sedentary work may resume in 2–6 weeks depending on recovery.

• Physically demanding work requires a longer recovery period.

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Nutrition & Lifestyle for Fusion Success

 

To promote bone healing:

• Eat a high-protein diet

• Maintain adequate calcium and vitamin D

• Avoid nicotine and tobacco products (nicotine significantly impairs fusion healing)

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When to Call Our Office

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• Fever over 101°F

• Increasing redness or drainage from the incision

• Worsening weakness

• Loss of bowel or bladder control

• Severe, uncontrolled pain

• Calf pain or swelling

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Follow-Up Care

 

You will have scheduled postoperative visits to:

• Monitor wound healing

• Assess neurological recovery

• Review X-rays to evaluate fusion and hardware

• Advance activity 

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​Every patient’s recovery is unique. Always follow your surgeon’s specific instructions.