Question: My daughter was in a car accident and severely injured her back. She had L5 spinal fusion surgery but now is in worse pain than before the operation. What are her options going forward?

Dr. Hibberd's answer:
The fusion process takes time. When did she have the surgery? It may be several months before the bone is solid, and if she has just had the surgery, this is healing time, and the fused spine must be kept in proper alignment. She must have been taught how to move properly, reposition, sit, stand, and walk. Her symptoms will gradually improve, so will her activity level. Right after the operation, your doctor may have recommended only light activity, like walking. As she regains strength, she will be able to slowly increase her activity level.
During the initial few months, if a back brace is prescribed, it is typically recommended to wear it for 6 weeks to 3 months after surgery. It is best to avoid excess motion and stress at the fused segments. It is during this time that the fusion bone mass is becoming established. She must avoid excess lifting (anything over 10 to 15 pounds), bending, or twisting. As the fusion matures, it is necessary to begin a reconditioning program.
It is well-established that people with spinal problems do best when they get in better shape. At approximately 3 months after surgery, a progressively more aggressive exercise program is typically started. This is often begun with the guidance of a physical therapist.
The improvement in back pain and function continues up to two years after spine fusion surgery. However, progress will not be accomplished unless the patient makes the effort. The long-term good results of a spine fusion require that the patient participate in a long-term self-directed exercise program.
Maintaining a healthy lifestyle and following her doctor's instructions will greatly increase her chances for a successful outcome.