Spinal fusion patients — Can preoperative cognitive-behavioral intervention help? 5 key notes

A new study published in Spine examines whether preoperative cognitive-behavioral intervention impacts the patient’s outcomes and return-to-work after lumbar spinal fusion surgery.

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The study authors examined patients with degenerative disc disease or spondylolisthesis who underwent lumbar spinal fusion either in the “usual care” group or a group that underwent cognitive-behavioral intervention before surgery. The researchers found:

 

1. There was no statistically significant difference in the two groups for the Oswestry Disability Index score one year after surgery.

 

2. Three months after surgery, the CBT group reported a 15 point reduction in ODI, and the reduction was maintained throughout the year.

 

3. There weren’t significant differences in the secondary outcomes one year after surgery. The secondary outcomes included:

 

• Catastrophizing
• Fear avoidance belief
• Work status
• Back and leg pain

 

4. The CBT did not translate to faster return-to-work.

 

5. Further research is necessary into targeted rehabilitation interventions among patients with higher levels of catastrophizing and fear avoidance beliefs.

 

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