Introduction to Pilates for People with Spinal Fusions

Information on Neutral Spine

During class we discussed what neutral spine means. Neutral spine is frequently referred to as the natural curves in the spine from the sagittal view.

spin scoliosis surgery

The cervical spine (neck) has 7 vertebrae and a lordotic curve that moves towards the front body.

The thoracic spine (mid-back) has 12 vertebrae and a kyphotic curve that moves towards the back body.  The ribs articulate with the thoracic vertebrae in the back body and the sternum in the front body. 

The lumbar spine (low back) has 5 vertebrae and a lordotic curve that moves towards the front body. 

When there is too much of a curve (hyperlordotic or hyperkyphotic) or too little of a curve (hypolordotic or hypokyphotic), we can experience discomfort. 

Considerations for People with Spinal Fusions

For people with spinal fusions, the fusion may change the natural curve of the spine.  Sometimes, the older instrumentation such as Harrington rods created a flattening of the natural curves where the individual is fused.  Sometimes for people who get fusion surgery as adults, the surgeons may restore the natural curves of the spine. 

We will not change the natural curves of the spine where it is fused.  Instead, we will work around the fusion (ribs, muscles, fascia, nervous, and areas above and below).  It is particularly important for people with fusions to maintain the natural curve of the vertebra above and below the spinal fusion.

Spinal Articulation

Traditionally, Pilates incorporates a lot of spinal articulation that involves movement patterns such as flexion, extension, side bending, and rotating.  These movement pattern take us away from neutral spine.   We will focus our work on stabilizing the spine, which will keep us in more of a neutral spine.  We may pass through these movement patterns in our daily life, but they aren’t necessarily the most helpful for our scoliosis or spinal fusion when exercising.