Cervical Fusion Protocol

Each physician has his/her own specific guidelines for the rehabilitation process. Deviations from

the protocol are dependent on prior level of function, general health of the patient, equipment available, goals of the patient, and specific orders written on the prescription. It is the treating therapist’s responsibility along with the referring physician’s guidance to determine the actual progression of the patient within the protocol guidelines.

Three goals throughout the cervical fusion physical therapy protocol are scapular stability, cervical stability, and functional activity. It is important that the patient follow the limitations set by the surgeon (lifting less than five pounds during the first two weeks, etc.) and gradually progress toward functional activities that do not place excessive stress on the cervical region.

In most cases patients will exhibit a functional cervical range of motion within a pain free range. Exercises should be designed to increase scapular and cervical stability within a safe limit. Once proper stabilization is demonstrated by the patient without cueing, a progression of exercises to further develop and improve stabilization can begin. Proper stabilization must be achieved with each attempted exercise prior to progressing to moderate/advanced stabilization exercises.

The following clinical observations require a consultation with the referring/consulting physician:

  1. Failure of incision to close or significant redness, swelling or pain in the area of incision.
  2. Unexpectedly high complaint of pain in comparison to pre-surgical state.
  3. Acute exacerbation of symptoms: significant increase of pain, sudden increase of radicular
  4. symptoms, and/or sudden loss of strength/ sensation/ reflexes.
  5. Development of new unexpected symptoms during the course of rehabilitation.

This is for information only and is not intended to substitute for sound clinical and professional knowledge.

Cervical Fusion 

General Considerations:

  • Decrease Swelling
  • Prevent Stiffness
  • Increase Activity Tolerance
  • Improve Stabilization


  • With Anterior Cervical Fusion – avoid extension
  • With Posterior Cervical Fusion – avoid flexion
  • Range of motion is patient dependent and based on Physician preference and the level and number of fusions.