Source: Spine Program at the Allen (2021 update); Allen OT Orientation Packet (2021)
📌 No Bending · No Lifting · No Twisting — standard for 6 weeks after most spine surgery; 4–6 months for fusions. Good body mechanics are for life.
| Procedure | Precautions |
|---|---|
| ACDF (anterior cervical discectomy & fusion) | No cervical hyperflexion/extension; no lifting >10 lb; avoid overhead activities (washing/styling hair is OK); collar per bracing rules. |
| Thoracic/lumbar decompression & fusion | No BLT. Return to work 2–6 weeks. No sitting at a 90° angle >30 min (reherniation risk). Use the spine kit for ADLs/iADLs. |
| Lumbar discectomy | No BLT. Return to work per MD. No driving on narcotics. No sitting at 90° >30 min. |
| Fusion at T4 or above | Patient may require a hard cervical collar — if orders/notes don't mention one, clarify with the PA before mobilizing out of bed. |
| Tumor removal | May be flat in bed 1–2 days; confirm mobility restrictions with the PA. Monitor closely for vasovagal syncope with first walks. |
As of the 2021 deck — verify with the team, these change.
| Surgeon | Notes |
|---|---|
| Dr. Lenke | No BLT for 6–12 months with osteotomy cases or fusions below L3. Squatting OK after 1 month. Cervical collar when out of bed with long fusions ending in the cervical or upper thoracic spine, for 6 months. Wants stair training for all patients going home (also needed for EOS imaging). |
| Drs. Lehman, Sardar, Dyrszka, Lombardi | Generally follow the Lenke-style precautions — check in with the team. |
| Surgeon | Notes |
|---|---|
| Dr. McCormick | Dural tears s/p tumor removal are managed case-by-case — check with the team after AM rounds and before PT regarding bed rest, HOB elevation, and therapy progression. Developed a classification grading clinical severity of spinal cord tumors. |
| Drs. Angevine, Mandigo, Reid | Check current team guidance. |
⚠️ Cross-campus note The CUMC orthopedic precautions sheet (2018) describes campus spine practice as: "No bending, lifting or twisting," rare use of TLSO/LSO, and soft C-collar at all times where ordered. It also flags a locally elevated dural-leak frequency — keep a low threshold for positional-headache screening (see Post-Op Care).