By: Haley Evans, Tim Lei

Laminectomy: Used to treat spinal stenosis, bony outgrowths, and sciatica pain caused by herniated disks

Lamina is directly removed from the spinous process

Enlarges spinal canal: relieves pressure on spinal cord and nerves. For herniated disks- surgeon will also remove herniated portion of disk

Return to ADL up to 3+ months

Used to treat: fractures of the spine, weak-unstable spine, spondylolisthesis, abnormal curvatures (scoliosis), arthritis, degenerative disc disease

Bone Grafts: Strips of bone grafts are placed at

various places of the vertebral body depending on pathology

Cages made with bone graft material placed between the vertebrae-used for degenerative disk disease

Hardware: Keep spine immobilized for bone grafts to heal and for new bone growth to occur Rods, screws, plates, cages

Used to treat lumbar disc herniation-current gold standard

http://www.uscspine.com/treatment/microdiscectomy.cfm

Also used with laminectomy

GOALS: Healing of surgical incision Ambulate without assistive device Decrease inflammation, pain Proper posture

AVOID: Sitting/long car rides for more than 30 minutes at a time Submersion in water Driving, sexual activities, household chores (for 2 weeks post op) Possible places/activities of infection “Warning signals”- over activity:

Persistent pain in neck, shoulders, arms Abnormal increase in morning pain/stiffness

Cardiovascular (light-moderate) Walking Recumbent Bike UBE -avoid rotation

After 24-48 hours patient is able to begin the following

Perform 3 times per day 2x5 Light walking-promotes healing

process and reduce pain Ankle pumps, glut sets, quad sets Short arc quad Alternate knees to chest Pelvic tilt (neutral) hold for 1-2

minutes Draw in abdomen exercise Lateral side bending Bird Dogs

Goals:

Maintain good posture

Increase AROM

Education of lifting mechanics

Increase cardio to 30 min/day

Sitting and walking progressions

Avoid:

Poor posture

Yard work

Cardiovascular

Walk- 1-3 miles

Elliptical

Aqua therapy- jog progress to run 4 way lower extremity AROM

ROM/ Strengthening

Prone press ups

Wall Squats

Bridge Progression

Abdominal crunches Isocrunch

bird/dog

Dead bug

Cat/cow

Goals:

Walk progress into Jog

Pain-free ADL’s

Lift 20 Ibs with ease

Avoid:

Sit ups

ROM/Stretching: (Add to previous) Magic 6 Hamstrings, glutes, piriformis, lower back Prone extensions Standing extensions Strengthening: Lat pull downs Rows Crate lifts Ball squats Pelvic hip thrusts Supermans Leg extensions Hamstring curls

Abdominals: • Isocrunch • Bird/dog • Dead bug

Proprioception: Standing on bosu ball both feet progress to eyes closed to single leg Lumbar twists on ball (also strengthens core) Hamstring curls with ball Cardiovascular Edurance: Elliptical Trainer Walk to Jog Progression Rowing machine-proper posture!! Sprint intervals in the pool

GOALS:

Resume all activities at 6 months post op

AVOID:

Sit ups

Excessive lifting

ROM/stretching Same as previous months

Strengthening Same as previous months

Squating w/o ball, add weight slowly and minimally

Push up progression: wall-knees-regular Supermans with added weight/machine

Speed Run/ Sprint intervals on treadmill T-test; keeping back straight Ladder drills Ropes

Power/Strength& Conditioning Squatting with added weight Box jumps: increase height slowly Russian dead lifts: low weight (FORM!) 4 way leg machine

Agility Cone hops-side to side/front to back

Proprioception Fitter w/ poles progress to none Slide board begin short

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