Original Article

European Spine Journal

, Volume 16, Issue 3, pp 339-346

First online:

The development of an evidence-based patient booklet for patients undergoing lumbar discectomy and un-instrumented decompression

  • A. H. McGregorAffiliated withBiosurgery and Surgical Technology, Faculty of Medicine, Imperial College London Email author 
  • , A. K. BurtonAffiliated withSpinal Research Unit, University of Huddersfield
  • , P. SellAffiliated withUniversity of Leicester Hospitals NHS Trust and Queen’s Medical Centre Nottingham NHS Trust
  • , G. WaddellAffiliated withUnumprovident Centre for Psychosocial and Disability Research, University of Cardiff

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Post-operative management after lumbar surgery is inconsistent leading to uncertainty amongst surgeons and patients about post-operative restrictions, reactivation, and return to work. This study aimed to review the evidence on post-operative management, with a view to developing evidence-based messages for a patient booklet on post-operative management after lumbar discectomy or un-instrumented decompression. A systematic literature search produced a best-evidence synthesis of information and advice on post-operative restrictions, activation, rehabilitation, and expectations about outcomes. Evidence statements were extracted and developed into patient-centred messages for an educational booklet. The draft text was evaluated by peer and patient review. The literature review found little evidence for post-operative activity restrictions, and a strong case for an early active approach to post-operative management. The booklet was built around key messages derived from the literature review and aimed to reduce uncertainty, promote positive beliefs, encourage early reactivation, and provide practical advice on self-management. Feedback from the evaluations were favourable from both review groups, suggesting that this evidence-based approach to management is acceptable and it has clinical potential.


Advice Booklet Patient education Post-operative management Rehabilitation Review Spinal surgery