Single-Level TLIF: Post-Fusion Rehabilitation

Patients will undergo transforaminal lumbar interbody fusion for degenerative pathology at
the L4-5 vertebral level. They will be randomized to one of three postoperative
rehabilitation groups. Group 1 will receive "structured early rehabilitation" beginning at 7
weeks. Group 2 will receive "Delayed rehabilitation" beginning at 13 weeks postoperatively.
Group 3 will undergo "Self Rehabilitation" beginning at 7 weeks postoperatively. Groups 1 and
2 will undergo rehabilitation under the supervision of a certified physical therapist for 10
total weeks. Group 3 will undergo non-supervised rehabilitation for 10 total weeks, and will
be given educational materials regarding which exercises to perform and at which intervals.

Inclusion Criteria:

i. Single-level L4-L5 TLIF for degenerative pathology, including: radiculopathy, neurogenic
claudication, intervertebral disc disease, facet joint disease, degenerative
spondylolisthesis, degenerative myelopathy degenerative kyphosis and scoliosis ii. Back
and/or leg pain iii. Failed at least 3 months of conservative treatment

Exclusion Criteria:

i. Older than 65 years of age ii. Prior spinal surgery excluding laminectomy/discectomy
iii. Greater than Grade 2 spondylolisthesis iv. Greater than 10 degrees scoliosis v. Not
worked for greater than 6 months or unemployed as a result of lumbar condition vi. History
of spinal infection