European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
-
Randomized Controlled Trial
Quality of life and disability: can they be improved by active postoperative rehabilitation after spinal fusion surgery in patients with spondylolisthesis? A randomised controlled trial with 12-month follow-up.
The aim of the study was to investigate the effectiveness of the postoperative 12-month exercise program compared to usual care on disability and health-related quality of life (HRQoL) in patients after lumbar spine fusion surgery (LSF). ⋯ The exercise intervention did not have an impact on disability or HRQoL beyond the improvement achieved by usual care. However, disability remained at least moderate in considerable proportion of patients.
-
Patient-reported outcome measures (PROMs) have become an important part of routine auditing of outcomes in spinal surgery in the UK. PROMs can be used to help assess the quality of care provided by surgical units by determining the comparative health status of patients, before and after surgery. This study was designed to review the PROMs used to assess outcomes in spinal surgery and to determine if they are fit for the purpose. ⋯ The consistent use of PROMs supports the comparison of outcomes from different studies, although there was minimal evidence regarding the specificity and sensitivity of these measures for use with lumbar spinal patients. Our review highlights the need to determine a consensus regarding the use and reporting of outcome measures within the lumbar spine literature.
-
Randomized Controlled Trial Comparative Study
The effect of short (2-weeks) versus long (6-weeks) post-operative restrictions following lumbar discectomy: a prospective randomized control trial.
We sought to evaluate how short (2-week) versus long (6-week) post-operative restrictions following lumbar discectomy impacted outcomes and reherniation rates for a period up to 1 year following surgery. ⋯ The results of this randomized trial suggest equivalent clinical outcomes irrespective of the length of post-operative restriction. From a clinical perspective, if patients are deemed at low risk for a reherniation event they may be confidence that early return to activity at 2 weeks will not compromise outcomes and may not adversely impact the risk of reherniation. Level of Evidence II.
-
The objective of this study is to identify the demographic and payer factors that are associated with lumbar fusion surgery. ⋯ Lumbar fusion surgery is not recommended in clinical practice guidelines for the top four principal diagnoses in this study. Yet, patients covered by certain types of insurance were found to be significantly associated with fusion surgery.