Evaluation of current surgeon practice for patients undergoing lumbar spinal fusion surgery in the United Kingdom

Rushton, Alison; White, Louise J.; Heap, Alison; Heneghan, Nicola R

doi:10.5312/wjo.v6.i6.483

Cited by 25 publications

(44 citation statements)

References 12 publications

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“…Just over half of the hospitals with more than one spinal surgeon reported variation in physiotherapy intervention based on differences in surgeon preferences, with the main difference being in the post-operative advice provided to patients regarding movement and activity restriction. These results are consistent with previous surveys conducted with both physiotherapists (Williamson et al 2007) and spinal surgeons (McGregor et al 2006, Rushton et al 2015 in the United Kingdom.…”

Section: Influence Of Individual Surgeon Preferences On Physiotherapysupporting

confidence: 92%

Physiotherapy management of patients undergoing lumbar spinal surgery: A survey of Australian physiotherapists

Gilmore¹,

McClelland²,

Davidson³

2016

NZJP

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Physiotherapists are commonly involved in the management of patients immediately before and after spinal surgery, however there is currently little known about what constitutes physiotherapy intervention in the hospital setting. This research aimed to describe the current physiotherapy practice in Australia for the peri-operative management of adults undergoing lumbar spinal surgery. A telephone survey was conducted using a structured questionnaire format. All Australian hospitals that admit one or more patients per week for lumbar spinal surgery were invited to take part in the survey. Sixty-four interviews were conducted (response rate 79%). All participating hospitals provided a physiotherapy service for patients undergoing lumbar spinal surgery, with the majority commencing the day following surgery. Physiotherapy intervention consistently included mobility and functional task training, exercise prescription and provision of an educational handout. However, there was considerable variability in the type of exercises prescribed, the advice given regarding post-operative movement and activity restrictions, the use of outcome measurement tools, and referral to inpatient and outpatient physiotherapy services. This survey provides physiotherapists and rehabilitation service providers with information regarding current clinical practice, and identifies the key focus areas for future research into the effectiveness of specific physiotherapy interventions.

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Section: Influence Of Individual Surgeon Preferences On Physiotherapysupporting

confidence: 92%

Physiotherapy management of patients undergoing lumbar spinal surgery: A survey of Australian physiotherapists

Gilmore¹,

McClelland²,

Davidson³

2016

NZJP

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“…A recent survey from the Netherlands identified a lack of consensus between surgeons (n=62) regarding prognostic factors and predictive tests aiding patient selection for LSFS, 6 contributing to a broad clinical heterogeneity of patients undergoing LSFS. Additionally, our survey of UK current practice found variation between surgeons regarding surgical procedure, for example, open or minimally invasive, instrumented or non-instrumented, different approaches, for example, transforaminal, and different numbers of levels fused, 7 dependent on the individual patient and their indications for surgery.…”

Section: Introductionmentioning

confidence: 94%

Patient journey following lumbar spinal fusion surgery (LSFS): protocol for a multicentre qualitative analysis of the patient rehabilitation experience (FuJourn)

et al. 2018

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IntroductionThere has been a 65% increase in lumbar spinal fusion surgery (LSFS) worldwide over the last 13 years, with costs of £26 million to the UK National Health Service annually. Patient dissatisfaction with outcome and persistent pain and disability incurs further costs. Three trials provide low-quality evidence for the role of physiotherapy. Our UK surveys investigating physiotherapy/surgeon practice concluded rehabilitation should be tailored to the individual patient owing to considerable clinical heterogeneity. This study will explore the perceptions of patients who undergo LSFS to inform precision rehabilitation.Methods and analysisA qualitative study, using interpretive phenomenological analysis, will recruit a purposive sample (n=40) to ensure patterns of similarity and difference in their journeys can be explored. In-depth semistructured interviews will be undertaken following discharge from hospital and at 12 months postsurgery. Patients’ preoperative and postoperative experiences, underlying attitudes and beliefs towards the surgical intervention, facilitators and barriers to recovery, adherence to advice and physiotherapy, experiences of rehabilitation and return to normal function/activity/work will be explored. A 12-month patient diary will provide real time access to patient data, capturing a weekly record of life as lived, including symptoms, medication, experiences of stages of recovery, rehabilitation adherence, healthcare professional appointments, attitudes, their feelings and experiences throughout their journey. Data will be analysed in a number of stages in accordance with interpretive phenomenological analysis, supported using NVivo software. Analysis of the first interviews and patient diaries will afford a rich density of data to build an overall understanding of the patients’ lived experiences, informing the 12-month interview. Strategies (eg, reflexivity) will ensure trustworthiness.Ethics and disseminationThe study has ethical approval (IRAS 223283). Findings will ensure that patient-driven data inform precision rehabilitation by understanding the patient journey. Findings will be disseminated through peer-reviewed journals and conferences.

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“…Mit 68 % liegt sie nur knapp unter der Response-Rate vergleichbarer Studien. Bei einer Befragung unter Wirbelsäulenchirurgen aller Abteilungen des NHS Trusts in Großbritannien konnten 31 von 42 (73,8 %) Fragebögen für die Auswertung berücksichtigt werden [10].…”

Section: Diskussionunclassified

“…Der Mangel an Studien erschwert die Einigung auf Standards in der Versorgung. Möglicherweise ist das die Ursache für die Heterogenität in der Versorgung nicht nur in Deutschland, sondern auch in anderen Ländern, wie die Befragung in Großbritannien [10] zeigt. Hier scheint das Deutsche Wirbelsäulenregister [11] übergeordnet eine geeignete Struktur zu geben, um die Behandlungsqualität zu überprüfen und daraus Handlungsempfehlungen für die klinische Praxis abzuleiten.…”

Section: Schlussfolgerungunclassified

Aktueller Status der Wirbelsäulenchirurgie in Deutschland – Ergebnisse einer Umfrage unter Mitgliedern der Deutschen Wirbelsäulengesellschaft

Marquardt

Bühn²,

Pieper³

et al. 2017

Z Orthop Unfall

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Mono- (MSS) and bisegmental spinal fusion (BSS) are frequently performed surgical interventions in German hospitals. Despite the high number of cases, only few data on treatment procedures and concepts for pre-, peri-, and postoperative care are available. The aim of the survey was to gain detailed insights into treatment procedures and medical approaches in elective MSS and BSS care in Germany in order to extract recommendations for improving patient care. Members of the German Spine Society (DWG) were sent a newsletter, inviting them to participate in a survey; 209 senior physicians agreed to do so. They were asked about length of stay (LOS), care concepts and outcome measurement. The data from 142 completed questionnaires were used in the analysis. In some aspects, there was a consistency in practice: preoperative patient information about the care process and discharge on the basis of qualitative criteria. However, there was also considerable variability in practice: in rehabilitation, restrictions, radiological control, pre- and postoperative outcome measurement and interdisciplinary coordination. More than half of the surveyed physicians declared that they followed a structured care plan. However, the treatment procedures in MSS and BSS care are very heterogeneous in German hospitals. It also became clear that this is particularly pronounced in aspects of treatment for which evidence is lacking. The results give important indications regarding aspects of treatment procedures and organizational structures that can be optimized for better patient care.

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Evaluation of current surgeon practice for patients undergoing lumbar spinal fusion surgery in the United Kingdom

Cited by 25 publications

References 12 publications

Physiotherapy management of patients undergoing lumbar spinal surgery: A survey of Australian physiotherapists

Physiotherapy management of patients undergoing lumbar spinal surgery: A survey of Australian physiotherapists

Patient journey following lumbar spinal fusion surgery (LSFS): protocol for a multicentre qualitative analysis of the patient rehabilitation experience (FuJourn)

Aktueller Status der Wirbelsäulenchirurgie in Deutschland – Ergebnisse einer Umfrage unter Mitgliedern der Deutschen Wirbelsäulengesellschaft

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