INTRODUCTION: Integrated care pathways may help to bridge evidence-practice gaps. To overcome the limitations of traditional researcher-centred and linear pathway development frameworks, a more user-centred approach is needed. In this study, we propose design thinking as a framework for developing integrated care pathways, specifically targeting rehabilitation of patients undergoing lumbar fusion surgery. DESCRIPTION: From 2017 to 2022, we utilized the design thinking infinity loop to create an evidence-based rehabilitation pathway for patients undergoing lumbar fusion surgery. This approach consisted of five phases: (1) empathizing with user needs, (2) defining problem statements, (3) ideating through meta-analysis, expert consensus, and brainstorming, (4) prototyping the pathway, and (5) testing its effectiveness and implementability. DISCUSSION: Through the proposed design thinking phases, innovative elements such as prehabilitation, early mobilization, and consistent communication emerged as the building blocks of the new rehabilitation pathway, addressing the needs of both patients and healthcare providers. These results serve as a practical guide for applying design thinking in developing integrated care pathways. CONCLUSION: Design thinking, represented by the infinity loop, presents a user-centred framework for developing integrated care pathways, and has the potential to effectively bridge the gap between evidence and clinical practice.