Best Recovery for Back Surgery Still Undefined

Physical therapy for lumbar spinal fusion results are not well understood

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Lumbar spinal fusion surgery is on the rise, mostly due to advances in technology. With this increase, a need to understand the best recovery process is becoming more and more important.

A recent study evaluates the effectiveness of physical therapy after lumbar spinal fusion.

The results of the research were inconclusive, showing the vital need for more research and standard best practices.

"Discuss post operation recovery options with your doctor."

Lumbar spinal fusion is a surgical procedure that stops the motion of the spine at a painful vertebral segment. The surgery involves grafting bone to an area of the spine that grows and fuses between two vertebral pieces creating one motionless segment.

It is a procedure most commonly used for those with low back pain due to degenerative disc disease or displacement of a vertebra.

It can also be used to treat a spine weakened or unstabilized by infections or tumors, fractures, scoliosis and deformity.

Alison Rushton, PhD, from the University of Birmingham in Birmingham, UK and associates analyzed four articles and two randomized controlled trials of outpatient physical therapy for patients with lumbar spinal fusion.

The trials included 188 participants who had undergone a post operation behavioral and exercise intervention. Length of the interventions ranged from one day to nine weeks and began somewhere between one day and three months after the surgery.

All study participants were over the age of 16 and experienced no complications with the fusion.

Both trials included inpatient or outpatient hospital exercise therapy and one included home exercises. Behavioral therapy was administered as psychomotor therapy with cognitive behavioral principles.

Psychomotor therapy uses the holistic approach that body and mind are deeply interrelated. It combines emotional, physical, cognitive, and symbolic responses and reactions in the body.

Assessment occurred three or four times between three months and 8 months after the surgery. These assessments included mental and physical health checks and return to work status.

The researchers found that intervention may work in the short and long term to reduce back pain. They also found that behavioral intervention may be more beneficial than exercise.

However, these results were minor and not statistically significant.

Dr. Rushton and team concluded that the effects of physical therapy for lumbar spinal fusion are unclear and require further research. A clinical trial with a low risk of bias and the inclusion of occupational outcomes would help define the best approach to recovery.

The study was published in the July edition of BMJ Open.

The researchers report no conflicts of interest.
 

Reviewed by: 
Review Date: 
September 11, 2012
Last Updated:
September 12, 2012