Physical Therapy Post Lumbar Discectomy May Be Ineffective

Does not change range of movement, overall impairment, disability or back pain

FRIDAY, June 17 (HealthDay News) -- The effectiveness of outpatient physical therapy after first single-level lumbar discectomy is unclear, due to a lack of conclusive evidence, according to a review published in the June 15 issue of Spine.

Alison Rushton, Ed.D., from the University of Birmingham in the United Kingdom, and colleagues reviewed available literature published before Dec. 31, 2009, to assess the effectiveness of outpatient physical therapy intervention after first single-level lumbar discectomy. A total of 16 randomized controlled trials, including 1,336 participants, aged 16 years or older, were identified. A meta-analysis was performed on eight studies with a total of 635 participants. Comparisons were made between interventions and control/sham, and between less versus more intensive interventions. Clinically relevant outcomes, including disability, function, and health, were assessed at three months (short term) and 12 months (longer term).

The investigators identified two trials with evidence of short-term disability reduction, which indicated that there may be greater benefit from more intensive rather than less intensive intervention, but their pooled effects were not statistically significant. No evidence was found for physical therapy changing the range of movement (ROM) in flexion, short-term overall impairment, or long-term disability or back pain. The intensity of intervention showed no evidence of affecting short- or long-term back pain, short-term ROM, or patients' satisfaction with longer term outcome. There was substantial heterogeneity in treatment effects.

"Inconclusive evidence for the effectiveness of outpatient physiotherapy post first lumbar discectomy has been identified," the authors write.

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