Summary of the best evidence for early mobilization after lumbar spinal fusion surgery: a systematic review.

PURPOSE: This study aimed to systematically identify, critically appraise, and synthesize the highest-quality evidence on early mobilization following lumbar spinal fusion surgery (LSF), thereby establishing an evidence-based framework to guide clinical nursing practice.

METHODS

Following the 6 S evidence model, we performed a comprehensive literature search across multiple databases and gray literature sources up to December 2024. Studies investigating early postoperative mobilization in LSF patients were screened for eligibility and rigorously assessed for methodological quality. Relevant evidence was extracted, categorized, and synthesized to develop evidence-based clinical recommendations.

RESULTS

Twenty-eight studies met the inclusion criteria, including 1 best practice guideline, 4 clinical guidelines, 6 systematic reviews, 1 evidence summary, 6 expert consensus statements, 4 randomized controlled trials (RCTs), and 6 cohort studies. Based on the synthesized evidence, 22 clinical recommendations were formulated, categorized into five key domains: Multidisciplinary collaboration and individualized activity planning, Patient-centered health education, Pre-ambulation functional assessment, Activity protocols and progression criteria, and Safety monitoring and risk mitigation strategies.

CONCLUSION

This evidence synthesis provides a standardized framework for early mobilization following LSF surgery. Implementation should be adapted to institutional resources and patient-specific factors, with continuous monitoring of clinical outcomes to ensure efficacy and safety.