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Restrictions were defined as movement limits (e.g., bending or twisting) and activity limits (e.g., driving or weightlifting) in degenerative spine surgery. Searches in PubMed, CENTRAL, Embase, and Web of Science identified four eligible studies. Evidence certainty was low across outcomes, preventing a definitive conclusion.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-effects-of-postoperative-activity-restrictions-on-outcomes-after-spine-surgery-a-systematic-review/450871/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-effects-of-postoperative-activity-restrictions-on-outcomes-after-spine-surgery-a-systematic-review/450871.png","ImageObject",300,407,{"name":92,"@type":93},"วิน","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-05","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the primary aim of the systematic review?","Question",{"text":112,"@type":113},"To investigate the effects of postoperative activity restrictions in spine surgery on patient-reported outcomes.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were postoperative activity restrictions defined in the included studies?",{"text":117,"@type":113},"As limitations on specific movements (such as bending or twisting) and on activities (such as driving or weightlifting).",{"name":119,"@type":110,"acceptedAnswer":120},"What did the review conclude about the effectiveness of postoperative activity restrictions?",{"text":121,"@type":113},"Current literature prevents a definitive conclusion; evidence certainty was low for all analyzed outcomes, making it difficult to support or oppose the use of restrictions.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},450871,1790832848,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},2336475104736,"https://ap-avatar.wpscdn.com/avatar/22000c4c5e0e5b17e70?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786591360781797222","The effects of postoperative activity restrictions on outcomes after spine surgery: a systematic review  \nKevin Mathew1^, Camille Flynn1, Will Karakash1^, Henry Avetisian1^, Jeffrey C. Wang1, Justin M. Lantz2^  \n1Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA; 2Division of Biokinesiology and Physical Therapy, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA  \nContributions: (I) Conception and design: K Mathew, C Flynn, W Karakash, H Avetisian; (II) Administrative support: JM Lantz, JC Wang; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: K Mathew, C Flynn, W Karakash; (V) Data analysis and  \ninterpretation: K Mathew, C Flynn; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.  \nCorrespondence to: Kevin Mathew, BS. Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, 1500  \nSan Pablo St, Los Angeles, CA 90033, [USA. Email: kmathew@usc.edu](USA. Email: kmathew@usc.edu).  \nBackground: Postoperative activity restrictions are commonly prescribed after spine surgery. However, it is unclear whether postoperative restrictions improve clinical or surgical outcomes after spine surgery. The primary aim of this study was to investigate the effects of postoperative activity restrictions in spine surgery on patient-reported outcomes. The secondary aim of the study was to assess whether these postoperative activity restrictions were associated with recurrence (reherniation), adverse events, and complications after  \nspine surgery.  \nMethods: This review included studies discussing degenerative spine surgery patients with postoperative activity restrictions, defined as limitations on specific movements such as bending or twisting, or activities such as driving or weightlifting. Electronic searches were conducted using PubMed, CENTRAL, Embase, and Web of Science databases in November 2024. The Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) and Risk Of Bias In Non-randomized Studies – of Interventions, Version 2 (ROBINS-I V2) tools were used to evaluate included studies for risk of bias. Meta-analysis was initially planned but was not performed due to the heterogeneity of the included studies. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to determine the certainty of the body of  \nevidence.  \nResults: A total of 3,723 studies were screened. Four studies met the inclusion criteria: one randomized controlled trial and two prospective single-arm cohort studies discussing open lumbar discectomy, and one prospective non-randomized two-group cohort study discussing percutaneous endoscopic lumbar discectomy (PELD) . Notably, there are no studies discussing restrictions after cervical or thoracic spinal surgery. Pain, function/disability, and data on recurrence (reherniation), adverse events and complications were collected from each study. The certainty of evidence was low for all outcomes analyzed, making it difficult to provide a  \ndefinitive conclusion for or against the use of postoperative activity restrictions in spine surgery.  \nConclusions: Current literature prevents a definitive conclusion regarding the effectiveness of postoperative restrictions in spine surgery. Future studies should address the limitations and heterogeneity of the current literature to provide the basis for standardized, evidence-based postoperative activity restriction protocols.  \nKeywords: Postsurgical precautions; limitations; percutaneous endoscopic lumbar discectomy (PELD); open  \nlumbar discectomy  \n^ ORCID: Kevin Mathew, 0009-0005-2425-961X; Will Karakash, 0009-0007-0777-2539; Henry Avetisian, 0000-0002-0726-7408; Justin M. Lantz, 0000-0002-0978-3211.  \n© AME Publishing Company. J Spine Surg 2025;11(4):1081-1094 | [https://dx.doi.org/10.21037/jss-25-87](https","cbCaiiKdl9Uo8FZa","https://ap.wps.com/l/cbCaiiKdl9Uo8FZa","pdf",656057,14,"English","# Background\n# Methods\n## Eligibility and definitions\n## Search and bias assessment\n# Results\n# Conclusions","[{\"question\":\"What was the primary aim of the systematic review?\",\"answer\":\"To investigate the effects of postoperative activity restrictions in spine surgery on patient-reported outcomes.\"},{\"question\":\"How were postoperative activity restrictions defined in the included studies?\",\"answer\":\"As limitations on specific movements (such as bending or twisting) and on activities (such as driving or weightlifting).\"},{\"question\":\"What did the review conclude about the effectiveness of postoperative activity restrictions?\",\"answer\":\"Current literature prevents a definitive conclusion; evidence certainty was low for all analyzed outcomes, making it difficult to support or oppose the use of restrictions.\"}]","The effects of postoperative activity restrictions on outcomes after spine surgery - a systematic review | PDF",1790734029,35]