Preparing the body before surgery may be as important as the treatment itself, especially for older adults undergoing major procedures. A new study has found that a structured prehabilitation programme involving exercise, nutrition guidance and psychological support can significantly improve recovery outcomes among elderly patients undergoing spinal fusion surgery.

The study, published in the journal Annals of Internal Medicine, revealed that patients aged 75 years and above who completed a four-week prehabilitation programme before surgery were 18 per cent less likely to experience postoperative complications compared with those who received only routine surgical care.

“This study provides evidence on the use of structured, multicomponent prehabilitation to reduce postoperative complications for spinal fusion surgery, specifically among older adults,” said Dr. Shibao Lu, director of orthopedics at Xuanwu Hospital, Capital Medical University, Beijing, who led the research team.

Spinal fusion surgery involves joining two or more vertebrae together so they heal into a single solid bone. The procedure is commonly performed to treat severe back pain caused by conditions such as degenerative disc disease, spinal instability, or compressed nerves.

Although spinal fusion is generally considered a safe procedure, older adults face higher risks during recovery. Researchers noted that people aged 75 years and above have nearly twice the risk of postoperative complications and delayed hospital discharge compared with younger patients.

The concept of prehabilitation has gained attention in recent years as doctors explore ways to make patients physically and mentally stronger before surgery. The approach aims to improve the body’s ability to handle surgical stress and support faster recovery.

For the study, researchers followed 164 patients undergoing spinal fusion surgery at three hospitals in China. Participants were divided into two groups — one received a four-week prehabilitation programme along with standard postoperative care, while the other received only routine care after surgery.

The prehabilitation programme included strength exercises, balance training, flexibility workouts and cardiovascular fitness activities. Patients also received nutritional advice focusing on adequate calorie and protein intake. In addition, they were provided support for improving sleep quality, managing pain, understanding medication use and coping with psychological challenges.

The results showed that around 75 per cent of patients who participated in prehabilitation experienced at least one complication within three months after surgery, compared with more than 91 per cent of patients who received only postoperative care.

Patients who underwent prehabilitation also had shorter hospital stays, spending an average of 12 days in the hospital compared with 14 days among those without pre-surgery preparation.

Recovery was also faster. Most patients in the prehabilitation group — 68 out of 79 — were able to get up and walk within 24 hours after surgery, compared with 55 out of 80 patients in the standard-care group.

Researchers found that women, people undergoing lower back spinal fusion, and those with higher education levels appeared to benefit the most from the programme.

However, the researchers cautioned that the findings may not apply equally to all countries because factors such as nutrition patterns, exercise habits, healthcare systems, hospital stay duration and waiting times before surgery can differ.

The study highlights the growing importance of preparing patients before major operations. For elderly individuals undergoing spinal surgery, improving strength, nutrition and mental readiness before the procedure may become an important part of achieving safer surgery and smoother recovery.