Lumbar spinal fusion patients’ demands to the primary health sector: evaluation of three rehabilitation protocols. A prospective randomized study

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

“…Only in the study of Christensen et al the commencement time of intervention was same three months as in our study [11,16]. However, the length of intervention in that study was only eight weeks and exercise protocol of training group was more intensive than the protocol used in the present study.…”

“…Thus far, a limited number of randomised controlled trials (RCTs) have been published and the evidence of exercise therapy in restoring the spinal functioning and improving disability or HRQoL after fusion surgery is weak [10][11][12][13][14][15][16]. The commencement time and structure of the rehabilitation programs in previous RCT's varies [10][11][12][13][14]17].…”

Cost-effectiveness evaluation of an RCT in rehabilitation after lumbar spinal fusion: a low-cost, behavioural approach is cost-effective over individual exercise therapy

“…Patients allocated to a lowcost regimen including a behavioural element performed significantly better than patients allocated to usual practice and equal to patients allocated to physiotherapist-guided, individual exercise therapy. The same study was extended to investigate whether the superior performance of the behavioural group was due to substitution of in-hospital care with service utilization in the primary health care sector, which was rejected [28]. However, the low-cost intervention is not fully supported as an optimal strategy until a full-scale economic evaluation, including extrahospital effects such as service utilization in the primary health care sector and return-to-work, is conducted.…”

A survey of the “surgical and research” articles in the European Spine Journal, 2006

“…As we have seen the European guidelines emphasise the importance of behavioural therapy in treating chronic low back pain, the paper by Soegaard [48] illustrates this well when applied to such patients after they had their back fused. After operation they randomly allocated their patients to three groups, a group shown a video and given advice, a group who were enrolled on an exercise program, and a group who were given the video, and then attended a Back Café -literally a café where they met other fusion patients, and had a physiotherapist skilled in rehabilitation who answered queries and anxieties of the group.…”