Abstract:
BACKGROUND:Patients who undergo lumbar disc surgery for herniated discs, are advocated two different postoperative management strategies: a watchful waiting policy, or referral for rehabilitation immediately after discharge from the hospital. A direct comparison of the effectiveness and cost-effectiveness of these two strategies is lacking. METHODS/DESIGN:A randomised controlled trial will be conducted with an economic evaluation alongside to assess the (cost-) effectiveness of rehabilitation after lumbar disc surgery. Two hundred patients aged 18-70 years with a clear indication for lumbar disc surgery of a single level herniated disc will be recruited and randomly assigned to either a watchful waiting policy for first six weeks or exercise therapy starting immediately after discharge from the hospital. Exercise therapy will focus on resumption of activities of daily living and return to work. Therapists will tailor the intervention to the individual patient's needs. All patients will be followed up by the neurosurgeon six weeks postoperatively. Main outcome measures are: functional status, pain intensity and global perceived recovery. Questionnaires will be completed preoperatively and at 3, 6, 9, 12 and 26 weeks after surgery. Data will be analysed according to the intention-to-treat principle, using a linear mixed model for continuous outcomes and a generalised mixed model for dichotomous outcomes. The economic evaluation will be performed from a societal perspective. DISCUSSION:The results of this trial may lead to a more consistent postoperative strategy for patients who will undergo lumbar disc surgery. TRIAL REGISTRATION:Netherlands Trial Register: NTR3156.
journal_name
BMC Musculoskelet Disordjournal_title
BMC musculoskeletal disordersauthors
Oosterhuis T,van Tulder M,Peul W,Bosmans J,Vleggeert-Lankamp C,Smakman L,Arts M,Ostelo Rdoi
10.1186/1471-2474-14-124subject
Has Abstractpub_date
2013-04-05 00:00:00pages
124issn
1471-2474pii
1471-2474-14-124journal_volume
14pub_type
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