One and two level fusions do NOT alter normal functional range of motion of the "lumbar spine". There is enough compensation in the hip joint and pelvis and remaining movable levels to allow functional movement without disability. Even three and four level fusions can allow reasonable everyday activities though there clearly is a diminished range of motion. Amazingly, a total lumbar spine fusion patient can function reasonably well such that at first site, would not be recognized.
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No. Most of your bending motion comes from the hips and this will not be affected. Also, the degenerative segments often have already lost their motion before surgery, so there may not be a noticeable decrease after fusion.
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The body is able to compensate in a variety of ways to allow a very functional range of motion following a spinal fusion. A fusion involves eliminating motion in only one section of the spine. Fortunately, the spine is made up of multiple vertebral levels that function together to allow moving and bending. Adjacent sections of the spine are able to compensate following a fusion and allow bending. In addition, hip and knee motion also contributes greatly to bending.
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You are most likely to have only 1 or 2 levels in your spine fused. You will technically sacrifice some motion from that fusion but the levels fused were painful segments and not moving normally before. Most patients notice very little change in motion from this operation.
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Absolutely not. It depends upon how many levels are fused. Patients that need fusions often have muscle spasms. They often have limitation of motion because of painful symptoms, that's why they're having the surgery in the first place. It's interesting; many patients after their fusion surgery say that they have increased motion. Although if we were to do a precise study of their back, they would lose a little bit of motion. But a one-level fusion, patients with relief of pain will actually notice clinically, which is the important aspect of this, an increased range of motion.
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A common misconception is that fusion surgery will prevent you from bending. In reality, patients who have fusion may even improve their range of motion after surgery. Many patients have such severe pain before surgery that they are unable to bend at all. After surgery, these patients can bend much more than they could before undergoing the procedure. Most of the bending that occurs when someone bends down is through the hip joints, which explains why fusion surgery does not necessarily affect the bending ability of patients.
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No, it does not mean you will not be able to bend. Each fusion obviously limits motion at one segment. Therefore, a one or single level fusion would be a relatively small change in biomechanics. However, a multiple level fusion would have much more of an impact on a patients' biomechanics. In general most patients are instructed after their spinal fusion to minimize bending in their spine, using the hips and knees instead so that they minimize the force on the remaining discs.
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Not at all. Usually if you are treating a fusion, you are dealing with a segment that is not normal. And there's usually not a lot of motion at that segment, so even if we were to remove all motion from that segment there are several other segments in the spine that compensate for that motion. So if you have a fusion, most likely you will not be able to detect any difference.
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No, it does not mean that. In fact, most people bend better than they did before surgery because the pain they were experiencing prior to surgery limited their ability to bend more than fusing one or two segments will limit their ability.
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If you have fusion and it is successful then that portion of the spine that you fused will not bend, but you will bend above and below and sometimes because your symptoms are better, you actually can bend more than before surgery. But you should be able to bend and perform most of your everyday activities that you need to do.
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For patients who have 1 or 2 levels fused, they may not notice a difference in bending ability. Some actually bend better after fusion because they hurt less. For longer fusions, patients with normal hips will still be able to bend forward enough to put on their socks.
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No. Very little bending capacity comes from the spine. It is from the hips.
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Actually each individual disc level contributes very little to the ability of patients to bend. More important to the final result in terms of range of motion is the patients pre-operative flexibility and the number of levels being fused.
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No; after about 3-6 months, you will be able to bend.
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Most fusions are limited to just a few levels. The other levels of the spine allow you to have continued mobility. Flexibility may be somewhat limited by your fusion particularly if it is over multiple levels.
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A 1-level or 2-level fusion of the lumbar spine does not appreciably decrease the overall range of motion of the spine. With greater lengths of fusion, however, patients do have a sense of stiffness and may have difficulty with twisting maneuvers. The ability to bend over is usually preserved as this is primarily a function of hip bending.
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No.
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Most fusions are limited to just a few levels. The other levels of the spine allow you to have continued mobility though it may be somewhat limited by your fusion particularly if it is over multiple levels.
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No. Half of the ability to bend at the waist comes from the lumbar spine, and the other half comes from the hips. Therefore, even if the entire lumbar spine was fused, there would still be some mobility. Most patients with a one or two level fusion do well, and complain very little about stiffness. Patients with three or more levels fused often notice a difference, but if the pain is gone, they are still pleased.
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The ability to bend under normal conditions is determined not only by movement between multiple spinal bones, but also by flexibility at the hips. Even if all of your spinal bones were fused, you will still have movement at the hips, which would allow partial bending. In addition to this, most fusions only involve a portion of the spinal bones, with the remaining bones remaining mobile. In that instance also, partial bending is preserved. Your surgeon should be able to provide his or her expectation regarding the degree of loss of range of motion, depending upon the nature of the operation planned.
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Patients who have spine fusions will lose some motion. However, most are able to compensate by the adjacent nonfused segments and/or by hip joint motion. Patients in my practice often have a single- or two-level fusion and find their effective motion increased because they have decreased pain, which often allows more motion than the patient had experienced preoperatively.
Fusing of the spine may increase stress and strains seen at levels adjacent to the fusion; however, it is unclear whether adjacent segment arthritis occurs secondary to fusion or due to the natural history of that person’s spinal condition. Newer technologies which decrease the stress at the adjacent levels may play a role in the development of adjacent segment arthritis. However, this has not yet been proven and we continue to follow this interesting concept as we perform studies on new motion sparing technologies.
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Ninety-five percent of all the bending, in terms of being able to touch your hands to the ground or your toes, involves your hip joints, not your spine. Thus, patients undergoing a one or two-level fusion typically have no loss of ability to touch their toes. If more than two levels of the spine are fused, there is some permanent loss of motion, but, again, more than 95% of all the flexion occurs at the hip joints, not the spine. Stretching the muscles about the pelvis and hips cannot be over emphasized.
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No, the degree of motion loss is minimal.
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Bending over involves the hip joints much more than the spine. Each spinal segment has about 10° - 15° of motion. While a fusion eliminates this motion, the remaining discs can accommodate this by sharing the lost motion over multiple segments. Most patients maintain sufficient mobility that bending over is minimally effected.
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Bending requires the participation of several joints including the hips, knee, ankles, and, of course, the spine. Out of these joints, the hips appear to be the most important one with respect to bending. Even if you had your whole lumbar spine fused, you could still bend forward and tie your shoes without much problem.
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It is interesting that many patients who have a successful fusion feel that they actually have more range of motion. It is not uncommon that a segment of the spine that needs to be fused causes muscle spasm which extends out over several segments. The patients must then use their muscles to splint to prevent motion, and once the source of the pain has been taken care of, patients will frequently find that they feel like they have more motion even though one of the segments of the spine has been fused. This perceived increased range of motion is certainly no loss of motion. This has clearly been shown to be the case in patients who undergo cervical spine fusions in the neck.
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Actually, most patients do not feel that bending forward is at all limited after a spinal fusion, probably because most of that motion occurs at the hips and other levels of the spine. Some stiffness is normal after surgery, but it is usually of very little lasting consequence.
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No, you will be able to move and bend as you wish. Although, you may not feel as flexible as you once were. But with the normal aging process we will all feel a little "stiff" at some point. You may just feel this way sooner.
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