Physiotherapy Post Lumbar Discectomy: Prospective Feasibility and Pilot Randomised Controlled Trial

Area of Science:

• Orthopedics and Sports Medicine
• Rehabilitation Sciences
• Clinical Trial Methodology

Background:

• A pilot randomized controlled trial was conducted in UK secondary care settings.
• The study focused on patients over 18 years old following primary, single-level lumbar discectomy.
• Trial registration: ISRCTN registry 33808269.

Purpose of the Study:

• To assess the acceptability and feasibility of trial procedures for post-lumbar discectomy patients.
• To evaluate the score distribution of the Roland Morris Disability Questionnaire (RMDQ).
• To examine the efficient functioning of trial components for future research.

Main Methods:

• Participants were randomized 1:1 to receive either a patient leaflet alone or physiotherapy outpatient management plus a patient leaflet.
• Blinded assessments were performed at 4 weeks (baseline) and 12 weeks post-surgery.
• Secondary outcomes included pain, function, quality of life, and medication use.

Main Results:

• Recruitment achieved 54% of eligible consented patients, with 39% loss to follow-up at 12 weeks.
• Both groups showed a trend towards reduced RMDQ scores at 12 weeks, indicating no floor effect.
• Participant adherence was good, and no adverse events were reported.

Conclusions:

• Physiotherapy and patient leaflet interventions were acceptable and showed a promising trend in reducing disability.
• A larger, adequately powered randomized controlled trial with a different design is recommended.
• Findings will inform the design of future trials, potentially using the RMDQ as the primary outcome measure.