The Role of Physical Therapy and Rehabilitation after Lumbar Fusion Surgery for Degenerative Disease: A Systematic Review

2016 ◽  
Vol 16 (10) ◽  
pp. S278 ◽  
Author(s):  
Marcella A. Madera ◽  
Sylvia E. Deily ◽  
Trent McGinty ◽  
Devender Singh ◽  
George W. Tipton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Physical Therapy ◽  
Lumbar Fusion ◽  
Degenerative Disease ◽  
Fusion Surgery ◽  
Lumbar Fusion Surgery

scholarly journals The role of physical therapy and rehabilitation after lumbar fusion surgery for degenerative disease: a systematic review

2017 ◽  
Vol 26 (6) ◽  
pp. 694-704 ◽  
Author(s):  
Marcella Madera ◽  
Jeremy Brady ◽  
Sylvia Deily ◽  
Trent McGinty ◽  
Lee Moroz ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Psychosocial Support ◽  
Lumbar Fusion ◽  
Postoperative Management ◽  
Current Evidence ◽  
Level Of Evidence ◽  
Fusion Surgery ◽  
Lumbar Fusion Surgery ◽  
Starting Point ◽  
Patient Reported

OBJECTIVEThe purpose of this study was to provide a systematic and comprehensive review of the existing literature regarding postfusion rehabilitation.METHODSUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the authors conducted an exhaustive review of multiple electronic databases. Potential articles were screened using inclusion/exclusion criteria. Two authors independently analyzed these studies using predefined data fields, including study quality indicators such as level of evidence and availability of accepted patient-reported outcomes measures. These findings were synthesized in a narrative format. A third author resolved disagreements regarding the inclusion of a study.RESULTSTwenty-one articles with I or II levels of evidence were included in the review. The authors divided the findings of the literature review into several groups: rehabilitation terminology, timing and duration of postfusion rehabilitation, the need for rehabilitation relative to surgery-related morbidity, rehabilitation's relationship to outcomes, and cognitive and psychosocial aspects of postsurgical rehabilitation. Current evidence generally supports formal rehabilitation after lumbar fusion surgery. Starting physical therapy at the 12-week postoperative mark results in better outcomes at lower cost than an earlier, 6-week start. Where available, psychosocial support improves outcomes. However, a number of the questions could not be answered with high-grade evidence. In these cases, the authors used “best evidence available” to make recommendations. There are many cases in which different types of caregivers use clinical terminology differently. The data supporting an optimal protocol for postfusion rehabilitation remains elusive but, using the data available, the authors have crafted recommendations and a model protocol, which is currently undergoing prospective study.CONCLUSIONSRehabilitation has long been a common feature in the postoperative management of patients undergoing spinal fusion. Although caregivers from multiple disciplines agree that the majority of their patients will benefit from this effort, the supporting data remain sparse. In creating a model protocol for postlumbar fusion rehabilitation, the authors hope to share a starting point for future postoperative lumbar fusion rehabilitation research.

Lumbar Fusion Surgery for Patients With Back Pain and Degenerative Disc Disease: An Observational Study From the Canadian Spine Outcomes and Research Network

2021 ◽  
pp. 219256822098547
Author(s):  
Nathan Evaniew ◽  
Ganesh Swamy ◽  
W. Bradley Jacobs ◽  
Jacques Bouchard ◽  
Roger Cho ◽  
...  
Keyword(s):  
Back Pain ◽  
Degenerative Disc Disease ◽  
Short Form ◽  
Lumbar Fusion ◽  
Research Network ◽  
Disc Disease ◽  
Fusion Surgery ◽  
Degenerative Disc ◽  
Lumbar Fusion Surgery ◽  
Related Quality

Study Design: Uncontrolled retrospective observational study. Objectives: Surgery for patients with back pain and degenerative disc disease is controversial, and studies to date have yielded conflicting results. We evaluated the effects of lumbar fusion surgery for patients with this indication in the Canadian Spine Outcomes and Research Network (CSORN). Methods: We analyzed data that were prospectively collected from consecutive patients at 11 centers between 2015 and 2019. Our primary outcome was change in patient-reported back pain at 12 months of follow-up, and our secondary outcomes were satisfaction, disability, health-related quality of life, and rates of adverse events. Results: Among 84 patients, we observed a statistically significant improvement of back pain at 12 months that exceeded the threshold of Minimum Clinically Important Difference (MCID) (mean change -3.7 points, SD 2.6, p < 0.001, MCID = 1.2; 77% achieved MCID), and 81% reported being “somewhat” or “extremely” satisfied. We also observed improvements of Oswestry Disability Index (-17.3, SD 16.6), Short Form-12 Physical Component Summary (10.3, SD 9.6) and Short Form-12 Mental Component Summary (3.1, SD 8.3); all p < 0.001). The overall rate of adverse events was 19%. Conclusions: Among a highly selective group of patients undergoing lumbar fusion surgery for degenerative disc disease, most experienced a clinically significant improvement of back pain as well as significant improvements of disability and health-related quality of life, with high satisfaction at 1 year of follow-up. These findings suggest that surgery for this indication may provide some benefit, and that further research is warranted.

The validity of using activity monitors to detect step count after lumbar fusion surgery

2018 ◽  
Vol 42 (6) ◽  
pp. 863-868 ◽  
Author(s):  
Sarah J. Gilmore ◽  
Megan Davidson ◽  
Andrew J. Hahne ◽  
Jodie A. McClelland
Keyword(s):  
Lumbar Fusion ◽  
Step Count ◽  
Fusion Surgery ◽  
Activity Monitors ◽  
Lumbar Fusion Surgery

scholarly journals Effect of the duration of chronic low back pain on pain sensitivity of patients undergoing lumbar fusion surgery

Pain medicine ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 8-15
Author(s):  
Mei-ping Qian ◽  
Mei-rong Dong ◽  
Fang Kang ◽  
Juan Li
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Hospital Stay ◽  
Chronic Low Back Pain ◽  
Pain Sensitivity ◽  
Lumbar Fusion ◽  
Low Back ◽  
Fusion Surgery ◽  
Lumbar Fusion Surgery

Background: chronic low back pain is a serious social problem. In recent years, patients who choose lumbar fusion surgery due to chronic low back pain has been increasing. Pre-existing chronic pain has been associated with severe postoperative pain. In this study, we have sought to prospectively analyze the association between the duration of chronic low back pain and pain sensitivity after lumbar fusion surgery. Methods: 400 patients who underwent lumbar fusion surgery were divided into three groups based on the duration of chronic pain. During the first postoperative day, the maximum pain scores of each patient day and night, the pain scores at the day of discharge, the consumption of postoperative analgesics and the length of hospital stay were recorded. Results: of 400 patients recruited, 369 patients completed the experiment. There was no significant difference in gender, age, height, weight, pre-operative pain at rest, and operation time in the three groups. During the day, the pain sensitivity of the three groups were 1.71 ± 0.66, 2.40 ± 0.74, 2.90 ± 0.80. During the night, the pain sensitivity of the three groups were 3.45 ± 0.81, 4.31 ± 1.06, 4.86 ± 1.05. At the day of discharge, the pain sensitivity of three groups were 1.26 ± 0.46, 1.47 ± 0.58, 1.96 ± 0.64. There were significant differences in pain sensitivity among the three groups during the day and night on the first postoperative day and at the day of discharge (p < 0.05). The length of hospital stay (7.31 ± 1.36 days, 8.82 ± 1.48 days, 9.60 ± 1.61 days) and analgesic consumption (25.04 ± 36.56 mg, 33.52 ± 24.04 mg, 45.15 ± 24.89 mg, morphine equivalent) were also significant differences (p < 0.05). Conclusion: we found the duration of chronic low back pain before lumbar fusion surgery affects patient’ postoperative pain sensitivity, consumption of analgesic drugs and hospital stay. The longer the preoperative chronic pain lasts, the higher the postoperative VAS score is, the more analgesic drugs were consumed, and the longer hospital stay is.

Sign in / Sign up

Export Citation Format

Share Document