A Controlled Study of 895 Consecutive Patients With 1 Year Follow Up.
Orthopedics
October 1995 Volume 18 Number 10
Brian W. Nelson MD. Elizabeth O’ Reily RN. Mark Miller PT. Mark Hogan PT.
Charles E. Kelly MD. Joseph A Wegner MD.
Physicians Neck and Back Clinics, Minneapolis, Minnesota
Study Outcomes & Clinical Relevance:
76 percent had good or excellent results. Patients with either radicular or referred leg pain (over half of all patients) responded just as well as patients with isolated low back pain.
Early Aggressive Exercise for Postoperative Rehabilitation After Discectomy
Spine
April 2000 Volume 25 Number 8
Danielsen JM. Johnsen R. Kibsgaard SK. Hellevik E.
Institute of Manual Therapy MO i Rana the institute of
Community Medicine, University of Tromso and Rana Hospital Mo i Rana, Norway
Study Outcomes & Clinical Relevance:
Vigorous medical exercise therapy started 4 weeks after surgery for lumbar disc herniation, reduced disability, and pain after surgery. Because no differences in clinical end points were observed, there is hardly any danger associated with early and vigorous training after operation for disc herniation.
As has been demonstrated again and again, active therapy prevails over passive or no therapy. In this study, surgery alone was insufficient to optimize outcomes, even when supplying patients with a few home exercises. Furthermore, several studies indicate spine patients (non-surgical and post-surgical) can tolerate very intensive conditioning programs. Given the present body of evidence, surgeons should be strongly encouraged to refer postoperative spine patients for supervised therapy by skilled professionals to ensure the best possible outcomes.