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COMPARISON OF CONSERVATIVE ADVICE VERSUS A PROGRESSIVE NON-AGGRAVATING SIX MONTH GYM REHABILITATION PROGRAMME POST-LUMBAR DISCECTOMY, PRELIMINARY ONE-YEAR FOLLOW-UP RESULTS



Abstract

Introduction Lumbar discectomy is now the operation of choice for lumbosacral radicular syndrome. Few studies of high quality have been performed on the post-surgical management of these cases (Ostelo RWJG, et al; Spine 2003). The studies that have been reported compared one exercise regime to another. This study compares an exercise group with a true control group involving no exercise or formal rehabilitation. This is a randomised controlled trial comparing post surgical lumbar discectomy management regimes.

Methods Ninety-three lumbar discectomy patients were randomised to two groups. Group A; the control group followed usual surgical advice which was to resume normal activity as soon as pain allowed. Group B; undertook a six month supervised non- aggravating gym rehab programme. Both groups were followed for a one year period using validated outcome measures and questionnaires (Roland Morris, Oswestry Low-back Score). The results are based on an intention-to-treat analysis.

Results Patients in both groups improved during the one-year follow-up period (P=0.001). However there was no statistical difference between groups at the clinical end point (Roland Morris P=0.83, Oswestry Low-back Index P=0.90). Group B patients returned to work seven days earlier than group A patients and had fewer days off work in the one year follow-up period but this difference was not statistically significant.

Discussion There was no statistical advantage gained by the patients who performed the gym rehabilitation programme after one year follow-up. These are the preliminary one-year results of a three-year follow-up study.

The abstracts were prepared by Professor Bruce McPhee. Correspondence should be addressed to him at Orthopaedics Division, The University of Queensland, Clinical Sciences Building, Royal Brisbane & Women’s Hospital, Herston, Qld, Australia