Rehabilitation following surgery for lumbar spinal stenosis

McGregor, Alison H.; Probyn, Katrin; Cro, Suzie; Doré, Caroline J; Burton, Kim; Balagué, Federico; Pincus, Tamar; Fairbank, Jeremy

doi:10.1002/14651858.cd009644.pub2

Cited by 41 publications

(35 citation statements)

References 53 publications

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“…39,40 Another Cochrane review has found similar themes in rehabilitation after decompression for lumbar stenosis. 41 Early active rehabilitation seems to lead to improved function and pain compared to usual care and the effect is small. These studies describe operations and patient selection processes where outcomes are expected to be very good in a high proportion of patients, so the effects of rehabilitation are very likely to be small.…”

Section: Rehabilitation As a Surgical Adjunctmentioning

confidence: 99%

Untitled

2017

IPMRJ

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This article presents a focused review on the role of rehabilitation in lumbar spine pain. Rehabilitation treatments are commonly used in the treatment of spine pain, before and after surgical operations. There is broad variation in rehabilitation treatments which makes assessment of effect very difficult. Rehabilitation is effective in the treatment of lumbar spine pain, and in some cases is as effective as surgery. Surgical outcomes can be superior for nerve compression and instability. Physical activity immediately after common spine operations improves outcomes but the incremental benefit appears small for most patients. When compared to surgical treatment, rehabilitation is remarkably safe. For patients with complex pathology, complicating medical conditions, difficult psychological or social situations, or those who do not improve after surgical intervention, intensive rehabilitation can often improve pain and function over many years.

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Section: Rehabilitation As a Surgical Adjunctmentioning

confidence: 99%

Untitled

2017

IPMRJ

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“…Another systematic review and meta-analysis has investigated the effectiveness of rehabilitation after spinal stenosis surgery from 3 existing RCTs [42] . The study's active rehabilitation programs focused on functional outcomes and used group or therapist-led exercise or educational materials encouraging activity starting between 6 and 12 wk after surgery.…”

Section: Research Directionsmentioning

confidence: 99%

“…The review as a whole concluded that despite the studies having low risk of bias, the small number of relevant studies rendered the quality of evidence as very low. Additional research including stratification of rehabilitation content is warranted [42] . With regards to rehabilitation after lumbar spinal fusion, several RCT's have highlighted that the integration of active rehabilitation and cognitive behavioral programs improve patient functional and pain outcomes significantly more than usual care [43][44][45] .…”

Section: Research Directionsmentioning

confidence: 99%

Evidence base and future research directions in the management of low back pain

Abbott

2016

WJO

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Low back pain (LBP) is a prevalent and costly condition. Awareness of valid and reliable patient history taking, physical examination and clinical testing is important for diagnostic accuracy. Stratified care which targets treatment to patient subgroups based on key characteristics is reliant upon accurate diagnostics. Models of stratified care that can potentially improve treatment effects include prognostic risk profiling for persistent LBP, likely response to specific treatment based on clinical prediction models or suspected underlying causal mechanisms. The focus of this editorial is to highlight current research status and future directions for LBP diagnostics and stratified care.

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“…Use of rehabilitation services after spine-related surgeries have been shown to improve both back and leg pain and improve overall back-related functional status compared with results for patients who receive no rehabilitation. 43,87,100 Physical therapy, including gait training, has also been shown to improve mobility and reduce the incidence of complications such as DVT and PE. 143 The time frame during which these rehabilitation programs have shown to have proven efficacy span the period from immediately postoperatively with inpatient rehabilitation services to programs starting 4 to 6 weeks postsurgery.…”

Section: Rationalementioning

confidence: 99%

The National Neurosurgery Quality and Outcomes Database Qualified Clinical Data Registry: 2015 measure specifications and rationale

Parker¹,

McGirt

Bekelis

et al. 2015

FOC

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Meaningful quality measurement and public reporting have the potential to facilitate targeted outcome improvement, practice-based learning, shared decision making, and effective resource utilization. Recent developments in national quality reporting programs, such as the Centers for Medicare & Medicaid Services Qualified Clinical Data Registry (QCDR) reporting option, have enhanced the ability of specialty groups to develop relevant quality measures of the care they deliver. QCDRs will complete the collection and submission of Physician Quality Reporting System (PQRS) quality measures data on behalf of individual eligible professionals. The National Neurosurgery Quality and Outcomes Database (N2QOD) offers 21 non-PQRS measures, initially focused on spine procedures, which are the first specialty-specific measures for neurosurgery. Securing QCDR status for N2QOD is a tremendously important accomplishment for our specialty. This program will ensure that data collected through our registries and used for PQRS is meaningful for neurosurgeons, related spine care practitioners, their patients, and other stakeholders. The 2015 N2QOD QCDR is further evidence of neurosurgery’s commitment to substantively advancing the health care quality paradigm. The following manuscript outlines the measures now approved for use in the 2015 N2QOD QCDR. Measure specifications (measure type and descriptions, related measures, if any, as well as relevant National Quality Strategy domain[s]) along with rationale are provided for each measure.

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Rehabilitation following surgery for lumbar spinal stenosis

Cited by 41 publications

References 53 publications

Untitled

Untitled

Evidence base and future research directions in the management of low back pain

The National Neurosurgery Quality and Outcomes Database Qualified Clinical Data Registry: 2015 measure specifications and rationale

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