title: Twelve-year follow-up of a randomized controlled trial of comprehensive physiotherapy following disc herniation operation.
abstract: OBJECTIVE
  To evaluate the long-term effects of postoperative comprehensive physiotherapy starting one week after lumbar disc surgery.
  
  
  METHODS
  Twelve-year follow-up of a three-armed, randomized, controlled, single-blinded clinical trial.
  
  
  METHODS
  Department of Physical Medicine & Rehabilitation.
  
  
  METHODS
  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.
  
  
  METHODS
  In the original study, patients had been randomly assigned to comprehensive physiotherapy, sham intervention (neck massage), or no therapy.
  
  
  METHODS
  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.
authors.affiliation: Department of Physical Medicine & Rehabilitation, Vienna Medical University, Vienna, Austria Gerold.Ebenbichler@meduniwien.ac.at.
authors.forename: Gerold R
authors.initials: GR
authors.lastname: Ebenbichler
authors.affiliation: Vienna Medical University, Vienna, Austria.
authors.forename: Silke
authors.initials: S
authors.lastname: Inschlag
authors.affiliation: Department of Physical Medicine & Rehabilitation, Vienna Medical University, Vienna, Austria.
authors.forename: Verena
authors.initials: V
authors.lastname: Pflüger
authors.affiliation: Department of Physical Medicine & Rehabilitation, Vienna Medical University, Vienna, Austria.
authors.forename: Regina
authors.initials: R
authors.lastname: Stemberger
authors.affiliation: Physical of Medicine & Rehabilitation, Salzburg Medical University, Salzburg, Austria.
authors.forename: Günther
authors.initials: G
authors.lastname: Wiesinger
authors.affiliation: Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Klaus
authors.initials: K
authors.lastname: Novak
authors.affiliation: Section of Medical Statistics, Medical University of Vienna, Vienna, Austria.
authors.forename: Krall
authors.initials: K
authors.lastname: Christoph
authors.affiliation: German Institute of Health Research, Bad Elster and Dresden, Germany.
authors.forename: Karl L
authors.initials: KL
authors.lastname: Resch
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000534:rehabilitation* / Q000601:surgery*; D008159:Lumbar Vertebrae; D008297:Male; D026741:Physical Therapy Modalities; D016037:Single-Blind Method; D013997:Time Factors
keywords: Disc herniation surgery; exercise therapy; long-term outcome; physiotherapy; randomized