Postoperative management of weight bearing and rehabilitation after lumbar spinal surgery

According to an OECD study from 2013, around 15 million spinal operations are performed in Germany every year.

Although the procedures for these operations are standardized and there has been some progress in the field of spinal surgery, the postoperative functional and clinical results are still unsatisfactory in a relatively large proportion of patients. Also compared to endoprosthetic operations of the hip and knee, “lumbar spinal surgery shows poorer functional and clinical results”, write Jan Bredow and his colleagues. For example, the success rate 1 to 2 years after lumbar disc surgery varies between 78 and 95 percent and between 46 and 75 percent 6-8 weeks postoperatively. The relatively high rate of dissatisfied patients may be related to the indication for surgery, the surgical technique, but also to the heterogeneity of the postoperative treatment.

Results

Patient training, accurate information about the postoperative course, information about limitations and stress possibilities as well as pain management seem to have an important role in the final outcome of the operation. Ideally, these procedures should be performed preoperatively or at the latest or repeatedly from the first postoperative day after lumbar spine surgery. Physiotherapy can have a positive impact on the clinical and functional outcome after lumbar disc, decompression and fusion surgery.

Discussion

Due to the heterogeneity of the intensity, duration and form of physiotherapy or rehabilitation, which are listed as interventions in the various studies, it is only possible to draw limited conclusions about general instructions for action on “physiotherapy” after spinal surgery.

Author(s)Source
Kron T and Bredow J, Eysel P, Oikonomidis Sunivadis, 08.09.2019 (german)
and
Der Orthopäde, 28.08.2019 (german/english)
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