Our Summary

This study looked at whether physical therapy (PT) after lumbar fusion surgery (a type of back surgery) resulted in better patient outcomes. They compared two groups of patients who had the surgery: one group who had PT afterwards, and one group who did not.

The study found that both groups had similar outcomes in terms of readmission rates, complications, and the need for further surgery. Patients who had PT had more fused levels in their spine, longer surgery times, and longer hospital stays.

However, the study found that PT did not significantly improve patient-reported outcome measures, which include things like disability levels and pain.

So, the study concluded that, based on their data, PT does not significantly improve outcomes after lumbar fusion surgery. The researchers suggested that doctors should consider this when deciding whether to recommend PT to their patients after this type of surgery.

FAQs

  1. Did the study find any significant improvement in patient outcomes with physical therapy after lumbar fusion surgery?
  2. What were the differences between the group that received physical therapy and the one that did not, post lumbar fusion surgery?
  3. Should doctors still recommend physical therapy to their patients after lumbar fusion surgery based on the study’s findings?

Doctor’s Tip

A helpful tip a doctor might give a patient about lumbar fusion is to follow their post-operative rehabilitation plan carefully. This may include specific exercises, physical therapy sessions, and restrictions on certain activities to help ensure proper healing and a successful outcome. It’s important for patients to communicate openly with their healthcare team about any concerns or difficulties they may be experiencing during their recovery process.

Suitable For

Patients who are typically recommended lumbar fusion surgery are those who have tried conservative treatments such as physical therapy, medications, and injections but have not had success in managing their pain and symptoms. They may have conditions such as degenerative disc disease, spondylolisthesis, spinal stenosis, or spinal fractures that are causing severe back or leg pain, weakness, numbness, or difficulty walking. These patients may have exhausted other treatment options and have significant functional limitations that impact their quality of life. Lumbar fusion surgery is a last-resort option for these individuals to stabilize the spine, reduce pain, and improve overall function.

Timeline

  • Before lumbar fusion surgery: Patients typically experience chronic back pain, leg pain, weakness, and numbness. They may have already tried non-surgical treatments such as physical therapy, medications, and injections with limited success. They will undergo pre-operative evaluations, imaging tests, and consultations with their surgeon to determine if lumbar fusion is the best treatment option for them.

  • During lumbar fusion surgery: The surgeon will make an incision in the back, remove damaged discs or bone, and stabilize the spine with hardware such as screws, rods, or cages. The surgery can take several hours and may involve fusing one or more vertebrae together.

  • After lumbar fusion surgery: Patients will typically stay in the hospital for a few days to a week for monitoring and pain management. They will gradually start physical therapy to help strengthen their core muscles, improve flexibility, and regain mobility. It may take several weeks to months for patients to fully recover and return to their normal activities.

  • Follow-up appointments: Patients will have regular follow-up appointments with their surgeon to monitor their progress, address any concerns, and make adjustments to their treatment plan if needed. They may also continue with physical therapy or other rehabilitation programs to optimize their recovery.

What to Ask Your Doctor

  1. Is physical therapy recommended after lumbar fusion surgery based on my specific case and condition?
  2. What are the potential benefits of physical therapy after lumbar fusion surgery?
  3. Are there any potential risks or drawbacks to undergoing physical therapy after lumbar fusion surgery?
  4. How soon after surgery can I start physical therapy, and what will the sessions entail?
  5. Will physical therapy help improve my pain levels and overall function after lumbar fusion surgery?
  6. Are there alternative rehabilitation options or treatments that may be more effective than physical therapy in my case?
  7. How long will I need to undergo physical therapy after lumbar fusion surgery, and what are the expected outcomes?
  8. Will my insurance cover the cost of physical therapy sessions after lumbar fusion surgery?
  9. Are there specific exercises or activities I should avoid during physical therapy to prevent any complications or setbacks?
  10. Can you provide me with more information or resources to help me make an informed decision about whether to pursue physical therapy after lumbar fusion surgery?

Reference

Authors: Heard JC, Lee YA, Lambrechts M, Brush P, Issa TZ, Kanhere A, Bodner J, Purtill C, Reddy YC, Patil S, Somers S, D’Antonio ND, Mangan JJ, Canseco JA, Woods BR, Kaye ID, Rihn JA, Hilibrand AS, Vaccaro AR, Kepler CK, Schroeder GD. Journal: Clin Spine Surg. 2023 Dec 1;36(10):419-425. doi: 10.1097/BSD.0000000000001483. Epub 2023 Jul 24. PMID: 37491717