Twelve-year follow-up of a randomized controlled trial of comprehensive physiotherapy following disc herniation operation.

OBJECTIVE

To evaluate the long-term effects of postoperative comprehensive physiotherapy starting one week after lumbar disc surgery.

DESIGN

Twelve-year follow-up of a three-armed, randomized, controlled, single-blinded clinical trial.

SETTING

Department of Physical Medicine & Rehabilitation.

PARTICIPANTS

Of 111 patients following first-time, uncomplicated lumbar disc surgery who participated in the original study and completed the treatment originally allocated, 74 ((67%; 29 (73%) physiotherapy, 22 (58%) sham therapy, 23 (68%) no therapy) completed a 12-year follow-up examination.

INTERVENTIONS

In the original study, patients had been randomly assigned to comprehensive physiotherapy, sham intervention (neck massage), or no therapy.

MEASURES

Low Back Pain Rating Scale; best score 0, worst score 130 points).

RESULTS

At 12 years after surgery, the group participating in comprehensive physiotherapy had significantly better functional outcomes, as rated on the Low Back Pain Rating Score, than the untreated group (mean difference: -13.2 (95% CI: (-25.4; -1.0)). Equally, there was a clinically relevant, non-significant difference between the sham therapy and no therapy (mean difference: -12.5 (95%CI: -26.1; 1.1)). Consequently, the Low Back Pain Rating Score outcome did not differ between physiotherapy and sham therapy (mean difference: -0.7 (95%CI: -14.2; 12.8)).

CONCLUSIONS

Participating in a comprehensive physiotherapy program following lumbar disc surgery may be associated with better long-term health benefits over no intervention, but may not be superior to sham therapy.