Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Aug 1;8(8):626-638.
doi: 10.1530/EOR-23-0015.

Rehabilitation after cervical and lumbar spine surgery

Tiago P Barbosa  1 , Ana Rita Raposo  1 , Paulo Diogo Cunha  1 , Nuno Cruz Oliveira  1 , Armanda Lobarinhas  1 , Pedro Varanda  1 , Bruno Direito-Santos  1
Affiliations
Review

Rehabilitation after cervical and lumbar spine surgery

Tiago P Barbosa et al. EFORT Open Rev. .

Abstract

The total number of spine surgeries is increasing, with a variable percentage of patients remaining symptomatic and functionally impaired after surgery. Rehabilitation has been widely recommended, although its effects remain unclear due to lack of research on this matter. The aim of this comprehensive review is to resume the most recent evidence regarding postoperative rehabilitation after spine surgery and make recommendations. The effectiveness of cervical spine surgery on the outcomes is moderate to good, so most physiatrists and surgeons agree that patients benefit from a structured postoperative rehabilitation protocol and despite best timing to start rehabilitation is still unknown, most programs start 4-6 weeks after surgery. Lumbar disc surgery has shown success rates between 78% and 95% after 2 years of follow-up. Postoperative rehabilitation is widely recommended, although its absolute indication has not yet been proven. Patients should be educated to start their own postoperative rehabilitation immediately after surgery until they enroll on a rehabilitation program usually 4-6 weeks post-intervention. The rate of lumbar interbody fusion surgery is increasing, particularly in patients over 60 years, although studies report that 25-45% of patients remain symptomatic. Despite no standardized rehabilitation program has been defined, patients benefit from a cognitive-behavioral physical therapy starting immediately after surgery with psychological intervention, patient education and gradual mobilization. Formal spine rehabilitation should begin at 2-3 months postoperatively. Rehabilitation has benefits on the recovery of patients after spine surgery, but further investigation is needed to achieve a standardized rehabilitation approach.

Keywords: cervical spine surgery; lumbar spine surgery; pain management; physical therapy; physiotherapy; post-surgery; postoperative rehabilitation.

PubMed Disclaimer

Conflict of interest statement

We declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Figures

Figure 1
Figure 1
Flow chart of database searches and included studies.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Low M Burgess LC & Wainwright TW. A critical analysis of the exercise prescription and return to activity advice that is provided in patient information leaflets following lumbar spine surgery. Medicina 201955 347. (10.3390/medicina55070347) - DOI - PMC - PubMed
    1. Madera M, Brady J, Deily S, McGinty T, Moroz L, Singh D, Tipton G, Truumees E. & for the Seton Spine Rehabilitation Study Group. The role of physical therapy and rehabilitation after lumbar fusion surgery for degenerative disease: a systematic review. Journal of Neurosurgery. Spine 201726 694–704. (10.3171/2016.10.SPINE16627) - DOI - PubMed
    1. Cancelliere C, Wong JJ, Yu H, Nordin M, Mior S, Pereira P, Brunton G, Shearer H, Connell G, Verville L, et al.Postsurgical rehabilitation for adults with low back pain with or without radiculopathy who were treated surgically: protocol for a mixed studies systematic review. BMJ Open 202010 e036817. (10.1136/bmjopen-2020-036817) - DOI - PMC - PubMed
    1. Wibault J Öberg B Dedering Å Löfgren H Zsigmond P & Peolsson A. Structured postoperative physiotherapy in patients with cervical radiculopathy: 6-month outcomes of a randomized clinical trial. Journal of Neurosurgery. Spine 201828 1–9. (10.3171/2017.5.SPINE16736) - DOI - PubMed
    1. Archer KR, Devin CJ, Vanston SW, Koyama T, Phillips SE, Mathis SL, George SZ, McGirt MJ, Spengler DM, Aaronson OS, et al.Cognitive-behavioral–based physical therapy for patients with chronic pain undergoing lumbar spine surgery: a randomized controlled trial. Journal of Pain 20161776–89. (10.1016/j.jpain.2015.09.013) - DOI - PMC - PubMed