A patient who underwent a TLIF about 41/2 months ago should be able to return to full range of motion. The problem is that the muscles will be deconditioned and not as pliable. This is due to the stiffness from the surgery itself but also from the original disorder that led to the TLIF in the first place.
You can go through all ranges of motion but complex motions (flexion with rotation) should be minimized until the patient has complete control of these individual motions (flexion only and rotation only). Bridging should be avoided until the patient has very good core control and painless complex motions.
Spinal articulation is the “rolling of the spine” to move each vertebra in a continued fashion. This needs to be done very slowly in a fusion patient and probably should wait until six months post surgery.
There are other disorders that spinal articulation should be avoided. Degenerative spondylolisthesis and degenerative scoliosis are two that come to mind. In these disorders, mobilization of the spine can lead to further slip or curve increase. Spine stiffness would be the order of the day with these two disorders.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.