This study sought to answer the following questions: What are the outcomes of physiotherapy post lumbar total disc replacement (LTDR) compared with patient self-mediated rehabilitation? Is a difference in outcomes related to the number of physiotherapy sessions?
This is a retrospective observational study of 600 patients post TDR. Patient outcomes for self-mediated rehabilitation (Group 1), 1-3 sessions of clinic-based physiotherapy (Group 2) and =4 sessions of clinic-based physiotherapy (Group 3) were analysed. Outcomes measures included the Oswestry Disability Index (ODI), Roland Morris Disability Questionnaire (RMQ), Short Form-36 Physical (SF-36 PCS) and Mental Subscale Components (SF-36 MCS), Visual Analogue Scale (VAS) for back and leg pain intensity. Patient's pre-operative baseline measures and post-operative follow-up measures at 3, 6, 12 and 24?months post-operatively were analysed.
Oswestry Disability Index and RMQ had significantly lower scores in Group 3 compared with Group 1 at 3, 6, 12 and 24?months follow-up. Significantly lower scores for Group 2 compared with Group 1 were observed for the ODI at 3?months follow-up and for the RMQ at 3 and 6?months follow-up. Significantly lower scores were observed in Group 3 compared with Group 1 for VAS back pain at 3?months and VAS leg pain at 6?months follow-up. Significantly higher scores in Group 3 compared with Group 1 were also observed in the SF-36 PCS at 6, 12 and 24?months. Significantly higher scores in Group 2 compared with Group 1 were observed at 6?months follow up. These trends were also observed when investigating the percentage of patients with a greater 50% improvement in the outcome measure.