Early physical therapy maintains alignment, decreases pain after cervicothoracic fusion
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Key takeaways:
- Patients who received early physical therapy after cervicothoracic fusion had better maintenance of alignment and improved pain scores.
- Results were compared with patients who received late physical therapy.
According to presented results, patients who started physical therapy within 6 weeks after cervicothoracic fusion had better maintenance of alignment and improved pain scores compared with patients who started therapy after 6 weeks.
“There's really a number of goals of [physical therapy], certainly to decrease pain, decrease stiffness, increase strength [and] increase range of motion,” Eeric Truumees, MD, said during his presentation at the North American Spine Society Annual Meeting.
“The thought is also that in doing those things — improving flexibility [and] improving strength — you’re actually going to eliminate or reduce the rate of future injury,” he added.
Truumees and colleagues performed a retrospective review of data from 58 patients who received early physical therapy (PT) and 47 patients who received late PT after posterior cervicothoracic fusion at three or more levels. Early PT was defined as therapy started within 6 weeks postoperatively, whereas late PT was defined as therapy started after 6 weeks postoperatively.
Outcome measures included radiographic improvements in cervical lordosis, T1 slope and C2-C7 sagittal plumbline, as well as VAS pain and Oswestry Disability Index (ODI) scores.
Truumees and colleagues found both cohorts demonstrated overall improvements in radiographic parameters and patient reported outcomes at 2 years postoperatively; however, Truumees noted significant differences in level of improvement between the cohorts. Patients who received early PT had greater percent improvements in cervical lordosis (25.2% vs. 14.2%), mean T1 slope (–5.6% vs. –2.6%) and mean C2-C7 sagittal plumbline (–15.2% vs. –11.7%) compared with patients who received late PT. Additionally, patients who received early PT had greater percent improvements in VAS pain scores (61.9% vs. 41%) and ODI scores (46.3% vs 29.6%).
“Early PT patients tended to get better correctional alignments, or at least maintenance of their alignment. They tend to have better improvements in their pain scores and less reported disability,” Truumees said.
“There were no significant differences in terms of problems like fascial dehiscence, wound complications or implant complications and pseudarthrosis,” Truumees added.
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Truumees E, et al. Paper 188. Presented at: North American Spine Society Annual Meeting; Oct. 18-21, 2023; Los Angeles.
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