This article is more than 5 years old. Information may no longer be current.
Winning paper shows that neither rehab nor booklet impacted back surgery results
Click Here to Manage Email Alerts
 Alison McGregor |
GOTHENBURG, Sweden — Two approaches thought to improve back surgery results — postoperative educational materials and rehabilitation programs — had no different effect on long-term outcomes with spinal discectomy or decompression surgery, according to a study presented here.
During the International Society for the Study of the Lumbar Spine (ISSLS) 38th Annual Meeting, the U.K. investigators that conducted the study received the 2011 ISSLS Clinical Prize.
Prof. Alison McGregor, of the Imperial College of London, presented the findings.
“We thought about doing some form of postoperative rehabilitation intervention because we know these people are de-conditioned before they have surgery, and then we know that also surgery itself also does further damage to the muscular structures,” McGregor said.
Study intent and findings
The intent of the study was to determine how functional outcomes on the Oswestry Disability Index (ODI) in two groups totaling 363 patients were affected by postoperative factors of usual care: a rehabilitation program started 6 weeks postoperatively, an informational booklet about post-surgical activities or no added information. Nearly 300 patients completed the study through the 12-month end point,
According to the findings, the effect of rehabilitation on the ODI was -2.7 and the effect of the booklet was 2.7.
“We found no positive impact of any intervention on the long-term outcome of surgery. The rehabilitation, though, did seem to provide a significant impact on leg pain at 1 year,” McGregor said.
One of the groups, which only received a special booklet modeled after the highly-successful publication, The Back Book, to read on their own, showed a slower recovery. However, the information contained in the booklet was liked by 90% of participants who received it, McGregor noted, adding overall compliance in the study was good.
‘Some negative messages’
However, “some negative messages still got through,” McGregor said, since leg pain in the rehabilitation group was better than in the booklet group at final follow-up.
“There was some indication from these results that the type of surgical procedure did impact the type of improvement the patient had with discectomy patients seeming to benefit more from just getting some information and the [decompression patients] needing some form of intensive rehabilitation,” she said.
McGregor theorized that the differing results by procedure could relate to the younger age of discectomy patients and older age of those who got decompressions and how such age groups respond differently to their randomized approach, something her team did not study.
Neither intervention was more cost-effective than what is now the standard used in the United Kingdom, based on the findings.
Reference:
- McGregor A, Doré, Morris T, et al Function after spinal treatment, exercise and rehabilitation (FASTER): A factorial randomized trial to determine whether the functional outcome of spinal surgery can be improved. Paper #P53. Presented at the International Society for the Study of the Lumbar Spine 38th Annual Meeting. June 14-18, 2011. Gothenburg, Sweden.
Follow
OrthoSuperSite.com on Twitter