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European Spine Journal

, Volume 26, Issue 3, pp 905–912 | Cite as

The effect of short (2-weeks) versus long (6-weeks) post-operative restrictions following lumbar discectomy: a prospective randomized control trial

  • Christopher M. BonoEmail author
  • Dana A. Leonard
  • Thomas D. Cha
  • Joseph H. Schwab
  • Kirkham B. Wood
  • Mitchel B. Harris
  • Andrew J. Schoenfeld
Original Article

Abstract

Purpose

We sought to evaluate how short (2-week) versus long (6-week) post-operative restrictions following lumbar discectomy impacted outcomes and reherniation rates for a period up to 1 year following surgery.

Methods

This study included 108 patients undergoing index lumbar discectomy. Patients were randomized immediately following surgery. Outcomes included back and leg visual analog pain scales (VAS), Oswestry Disability Index (ODI), and reherniation rates at 2-weeks, 6-weeks, 3-months, and 1-year following surgery. Differences in reherniation rates were analyzed using Fisher’s exact test. VAS and ODI scores were evaluated using Student’s t test.

Results

Six patients (11%) in the 2-week restriction group had a reherniation event and four patients (7%) in the 6-week restriction group experienced a reherniation (p = 0.52). VAS back pain (p < 0.001), leg pain (p < 0.001), and ODI scores (p < 0.001) were significantly improved for both cohorts as compared to baseline at the 2-week time point and remained significantly improved through 1-year [VAS back (p < 0.001); VAS leg (p < 0.001); ODI (p < 0.001)]. No significant differences in ODI, VAS back, or VAS leg scores were detected at any of the time points between the 2- and 6-week restriction groups.

Conclusions

The results of this randomized trial suggest equivalent clinical outcomes irrespective of the length of post-operative restriction. From a clinical perspective, if patients are deemed at low risk for a reherniation event they may be confidence that early return to activity at 2 weeks will not compromise outcomes and may not adversely impact the risk of reherniation.

Level of Evidence II.

Keywords

Lumbar discetomy Rehabilitation Post-operative restriction Reherniation Randomized trial 

Notes

Compliance with ethical standards

Conflict of interest

Stipend, JAAOS, Deputy Editor; Stipend, NASS President; United Health Care, consulting; Expert Witness, CRICO, Best Doctors, Consultant.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Christopher M. Bono
    • 1
    Email author
  • Dana A. Leonard
    • 1
  • Thomas D. Cha
    • 2
  • Joseph H. Schwab
    • 2
  • Kirkham B. Wood
    • 3
  • Mitchel B. Harris
    • 1
  • Andrew J. Schoenfeld
    • 1
  1. 1.Department of Orthopaedic Surgery, Brigham and Women’s HospitalHarvard Medical SchoolBostonUSA
  2. 2.Department of Orthopaedic Surgery, Massachusetts General HospitalHarvard Medical SchoolBostonUSA
  3. 3.Department of Orthopaedic SurgeryStanford University Medical CenterStanfordUSA

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