L4-L5 fusion
Reply With QuoteThe biggest risk to this individual getting back under the bar is going to be their value system and how much they interpret the word of their neurosurgeon as being the "one true opinion" on the matter. The fact of the matter is the overwhelming majority of the cases of back surgery are caused by things not in any way shape or form related to lifting, let alone lifting heavy weights. The vast majority of back pain that results in surgery has no identifiable mechanism of injury, and it is a very, very slim minority of back surgery cases that arise from an episode of heavy weight lifting.Originally Posted by Ridgeback303
The cascade of failing adjacent discs post-lumbar fusion is there regardless of whether the individual trains or not. Now, what is interesting is that people who regularly train with heavy weights have a demonstrated protective effect from degeneration in the spine, and even more interesting, this is even seen in elite lifters (presumably a population that "overdoes" it). If lifting heavy weights jeopardizes the adjacent discs post lumbar fusion, why does it show a protective effect in a normal spine? Why is this protective effect seen in the most elite lifters who have the greatest frequency of training with supra-physiological loads? It would appear to me, after many years of working in the rehabilitation field, that the biggest discrepancy between the literature and medical practice is due to the threat of litigation, with a surgeon not feeling compelled to stay up to date on the biomechanical studies coming in a close second. Surgeons do surgery, and once they have done surgery, they have to answer for that surgery if anything ever goes wrong with that surgery, so, oftentimes the recommendations are seemingly more to protect the license holder from further litigation, because in a case of alleged medical malpractice, this surgeon would be judged according to what a reasonable surgeon in his discipline would do. There aren't but a few neurosurgeons with a heavy weight lifting background, and therefore, statistics would play heavily into the favor of a peer in his field stating that heavy weight lifting after a fusion is far outside of the standard of care. Reckless. Egregious, even.
Next there is the issue of hardware failure. The loads placed on the lumbar spine in quiet sitting have been suggested in many studies to be several multiples of your bodyweight. It is highly unlikely most trainees will ever get to multiples of their bodyweight in a squat, not to mention, biomechanically load on your back does not equal load on your lumbar discs because the kinetic chain does not end at the sacrum like it does in sitting. Trauma is more likely to cause hardware failure, but, that is something you can't completely control for. He is more likely to have hardware failure by getting hit by a bus, or, even more insidiously, eventual hardware failure due to osteoporosis due to lack of training later in life. Did the neurosurgeon also tell your husband that the risk of him falling off a ladder and completely destroying the fusion is amplified by the diabetic neuropathy and that a sane person would never, ever climb a ladder should they have a prior lumbar fusion and diabetic neuropathy? Fact of the matter is, training may be the only way to rigidize his spine and provide the work hardening effect to improve his ability to do his manual labor, and, in many ways, may provide a protective effect against the absolute chaos in the real world. Well programmed training is the polar opposite of chaos. It can be tightly controlled to make it safe for virtually anyone. I have trained dozens of patients and clients through the years with relatively radical lumbar spine and cervical spine surgeries without a single negative effect worth mentioning. The one post lumbar surgery client I had that actually may need a second surgery had his exacerbation come about during a period where they wanted to start running in preparation for a marathon.
