title: Outcome of physiotherapy after surgery for cervical disc disease: a prospective randomised multi-centre trial.
abstract: BACKGROUND
  Many patients with cervical disc disease require leave from work, due to long-lasting, complex symptoms, including chronic pain and reduced levels of physical and psychological function. Surgery on a few segmental levels might be expected to resolve disc-specific pain and reduce neurological deficits, but not the non-specific neck pain and the frequent illness. No study has investigated whether post-surgery physiotherapy might improve the outcome of surgery. The main purpose of this study was to evaluate whether a well-structured rehabilitation programme might add benefit to the customary post-surgical treatment for cervical disc disease, with respect to function, disability, work capability, and cost effectiveness.
  
  
  METHODS
  This study was designed as a prospective, randomised, controlled, multi-centre study. An independent, blinded investigator will compare two alternatives of rehabilitation. We will include 200 patients of working age, with cervical disc disease confirmed by clinical findings and symptoms of cervical nerve root compression. After providing informed consent, study participants will be randomised to one of two alternative physiotherapy regimes; (A) customary treatment (information and advice on a specialist clinic); or (B) customary treatment plus active physiotherapy. Physiotherapy will follow a standardised, structured programme of neck-specific exercises combined with a behavioural approach. All patients will be evaluated both clinically and subjectively (with questionnaires) before surgery and at 6 weeks, 3 months, 6 months, 12 months, and 24 months after surgery. The main outcome variable will be neck-specific disability. Cost-effectiveness will also be calculated.
  
  
  CONCLUSIONS
  We anticipate that the results of this study will provide evidence to support physiotherapeutic rehabilitation applied after surgery for cervical radiculopathy due to cervical disc disease.
  
  
  BACKGROUND
  ClinicalTrials.gov identifier: NCT01547611.
authors: Department of Medical and Health Sciences, Physiotherapy, Faculty of Health Sciences, Linköping University, SE-58183 Linköping, Sweden. Anneli.Peolsson@liu.se.
authors: Anneli
authors: A
authors: Peolsson
authors: Birgitta
authors: B
authors: Öberg
authors: Johanna
authors: J
authors: Wibault
authors: Åsa
authors: Å
authors: Dedering
authors: Peter
authors: P
authors: Zsigmond
authors: Lars
authors: L
authors: Bernfort
authors: Ann-Sofi
authors: AS
authors: Kammerlind
authors: Liselott C G
authors: LC
authors: Persson
authors: Håkan
authors: H
authors: Löfgren
mesh_terms: D001696:Biomechanical Phenomena; D002574:Cervical Vertebrae / Q000503:physiopathology / Q000601:surgery*; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D019299:Decompression, Surgical / Q000009:adverse effects / Q000191:economics / Q000534:rehabilitation*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007403:Intervertebral Disc / Q000503:physiopathology / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000191:economics / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000191:economics / Q000534:rehabilitation*; D026741:Physical Therapy Modalities / Q000191:economics; D011446:Prospective Studies; D011843:Radiculopathy / Q000175:diagnosis / Q000191:economics / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function; D012107:Research Design; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome; D014938:Work Capacity Evaluation