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Rehabilitation After Lumbar Spine Surgery In Adults: A Systematic Review With Meta-Analysis London Spine Lumbar Stenosis

This article is a systematic review that examines the role of rehabilitation after surgery in patients with low back pain. The review includes randomized controlled trials (RCTs) on the effectiveness of rehabilitation for lumbar disc herniation, spinal stenosis, and spondylolisthesis. The researchers searched for relevant studies in multiple databases and assessed the risk of bias in each study. They found that a supervised active exercise program was effective in improving outcomes for patients with lumbar stenosis. In the case of spondylolisthesis, home exercises were found to reduce kinesiophobia compared to usual care. For disc herniation, supervised exercises were better than non-supervised exercises and advice in reducing pain and disability. However, the quality of evidence supporting these findings was low. The authors conclude that supervised exercise may be effective in improving pain and disability after lumbar surgery, but more research is needed for other conditions

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most experienced spinal centre in UK

Published article

CONCLUSIONS: Our research suggests that supervised exercise may be effective in improving patient’s pain and disability after lumbar surgery, but RCTs regarding lumbar spinal stenosis and lumbar spondylolisthesis are still scarce, with significant heterogeneity of proposed interventions.

Spine Lumbar Spinal Stenosis Expert. Best Spinal Surgeon UK
Abstract Background: The role of rehabilitation after surgery in patients with low back pain is well recognized. The aim of this systematic review is to summarize and update the existing evidence according to the type of clinical condition and rehabilitation approach. Methods: This systematic review included RCTs on the effectiveness of rehabilitation after surgery for,

Abstract

Background: The role of rehabilitation after surgery in patients with low back pain is well recognized. The aim of this systematic review is to summarize and update the existing evidence according to the type of clinical condition and rehabilitation approach.

Methods: This systematic review included RCTs on the effectiveness of rehabilitation after surgery for lumbar disc herniation, spinal stenosis, and spondylolisthesis. We searched the literature for randomized controlled trials indexed in MEDLINE, Embase, CINHAL, CENTRAL, Scopus, PEDro, and Web of Science databases, up to April 15, 2023. We used Cochrane Risk of Bias 2.0 tool to assess each study. We conducted a quantitative synthesis when population, intervention, control, and outcome were sufficiently homogeneous; otherwise, we conducted a qualitative analysis.

Results: Forty-five studies (3.036 subjects) were included and analyzed according to the population considered: lumbar stenosis (1 trial), spondylolisthesis (3 trials), and disc herniation (41 trials). Regarding lumbar stenosis, a supervised active exercise program appears to improve outcomes related to pain, disability, and quality of life both in the short- and mid-term (1 study, n = 60). Concerning spondylolisthesis, kinesiophobia is reduced in the home exercises group compared to usual care, at 3-months follow-up (3 studies, n = 98). For disk herniation, supervised exercises are better than non-supervised exercises to reduce pain (MD -1.14; 95% CIs -1.65, -0.62; 5 trials, n = 250) and disability (SMD -0.70; 95% CIs -1.14, -0.26; 4 trials, n = 175). Supervised exercises are better than advice in reducing pain (SMD -0.91; 95% CIs -1.61, -0.21; 5 trials, n = 341) and disability (SMD -0.80; 95% CIs -1.59, -0.01; 4 trials, n = 261), in the short-term. Supervised exercises are equal to no treatment in reducing pain and disability, at 3 and 6 months after intervention (2 trials, n = 166). These results are supported by a very low to low quality of evidence.

Conclusions: Our research suggests that supervised exercise may be effective in improving patient’s pain and disability after lumbar surgery, but RCTs regarding lumbar spinal stenosis and lumbar spondylolisthesis are still scarce, with significant heterogeneity of proposed interventions.

Keywords: Disc herniation; Exercise therapy; Low back pain surgery; Meta-analysis; Post-operative period; Rehabilitation; Spondylolisthesis; Stenosis.

The London Spine Unit : most experienced spinal centre in UK

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Rehabilitation after lumbar spine surgery in adults: a systematic review with meta-analysis

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Abstract Background: The role of rehabilitation after surgery in patients with low back pain is well recognized. The aim of this systematic review is to summarize and update the existing evidence according to the type of clinical condition and rehabilitation approach. Methods: This systematic review included RCTs on the effectiveness of rehabilitation after surgery for

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