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Published on: August 7, 2018
Twelve-year follow-up of a randomized controlled trial of comprehensive physiotherapy following disc herniation
Gerold R Ebenbichler1, Silke Inschlag2, Verena Pflüger3
1Department of Physical Medicine & Rehabilitation, Vienna Medical University, Vienna, Austria Gerold.Ebenbichler@meduniwien.ac.at.
Objective:
To evaluate the long-term effects of postoperative comprehensive physiotherapy starting one week after lumbar disc surgery.
Design:
Twelve-year follow-up of a three-armed, randomized, controlled, single-blinded clinical trial.
Setting:
Department of Physical Medicine & Rehabilitation.
Participants:
Of 111 patients following first-time, uncomplicated lumbar disc surgery who participated in the original study and completed the treatment originally allocated, 74 ((67%; 29 (73%) physiotherapy, 22 (58%) sham therapy, 23 (68%) no therapy) completed a 12-year follow-up examination.
Interventions:
In the original study, patients had been randomly assigned to comprehensive physiotherapy, sham intervention (neck massage), or no therapy.
Measures:
Low Back Pain Rating Scale; best score 0, worst score 130 points).
Results:
At 12 years after surgery, the group participating in comprehensive physiotherapy had significantly better functional outcomes, as rated on the Low Back Pain Rating Score, than the untreated group (mean difference: -13.2 (95% CI: (-25.4; -1.0)). Equally, there was a clinically relevant, non-significant difference between the sham therapy and no therapy (mean difference: -12.5 (95%CI: -26.1; 1.1)). Consequently, the Low Back Pain Rating Score outcome did not differ between physiotherapy and sham therapy (mean difference: -0.7 (95%CI: -14.2; 12.8)).
Conclusions:
Participating in a comprehensive physiotherapy program following lumbar disc surgery may be associated with better long-term health benefits over no intervention, but may not be superior to sham therapy.
