Abstract
Objective
To investigate, through a randomised, single blind, Quasi-experimental trial, whether immediate physiotherapy after lumbar micro-discectomy enables patients to become independently mobile more rapidly with no increase in risk of complications.
Background data
Although studies have demonstrated the efficacy of rehabilitation after lumbar discectomy, nos have looked at physiotherapy commencing immediately post-operatively.
Methods
Thirty patients were randomised to an immediate group commencing physiotherapy within two hours after surgery or a control group receiving physiotherapy on the first day after surgery. Outcome measures included the time taken for the patient to become independently mobile after surgery, Oswestry Disability Index and pain scores (VAS and short form McGill) collected pre-operatively and post-operatively at four weeks, and three months.
Results
The results indicated significantly reduced time to independent mobility (p=0.009) and return to work (p=0.002) in the immediate group. In that group, 47% of patients achieved discharge criteria on the day of surgery compared with 33% in the control group. There was no significant difference in disability and pain scores at four weeks and three months between the groups. Early mobilisation did not result in increased complications at 18 months after surgery.
Conclusions
Immediate physiotherapy following first time single level lumbar micro-discectomy enables patients to become independently mobile more rapidly and return to work sooner. Immediate physiotherapy may enable patients to experience earlier discharge with associated cost benefits to healthcare.
