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Spine

CAN PHYSIOTHERAPY EFFECTIVELY TREAT PATIENTS WITH LUMBAR RADICULAR SYNDROME SECONDARY TO MRI DEMONSTRABLE DISC PROLAPSE? A PRELIMINARY RANDOMISED TRIAL OF PATIENTS AWAITING LUMBAR MICRO-DISCECTOMY

The Society for Back Pain Research (SBPR) Annual General Meeting: ‘Spotlight on sciatica’



Abstract

Purpose of study and background

The primary aim of the study was to test the feasibility of conducting a full RCT with economic analysis and help to inform the provision of physiotherapy in a specific sub-group of patients with sciatica

Methods

60 patients waiting for primary, unilateral, single level, lumbar micro-discectomy surgery were recruited and randomised into two groups. The intervention group received a new spinal physiotherapy regimen. Primary outcome measure was the number of patients who did not require surgery at the time of consent clinic. Secondary measures were the Visual Analogue Scale (VAS) Oswestry Disability Index (ODI) and EQ5DL, taken at recruitment, 1 week before surgery and 2 weeks and 3 months after surgery.

Results

1 week before surgery, 3 patients of 30 (10.0%) in the non-physiotherapy group and 5 out of 29 (17.2%) in the physiotherapy group did not require surgery translating into a difference of −7.2% (95%CI-25.7% to 11.1%) in favour of the physiotherapy group but not statistically significant. All the secondary outcome measures demonstrated that patients in the physiotherapy group had a greater improvement but this was not statistically significant due to the small trial numbers.

Conclusion

This study informs the feasibility of planning of a large RCT with regard to recruitment, adherence to treatment and outcome measures. The observational data shows that physiotherapy can have a positive impact on these patients with sciatica which diminishes with time. These results provide a framework for further studies.

This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0110-21158). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.


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Conflicts of interest; None

Sources of funding; NIHR Research for Patient Benefit Programme (RfPB)

This abstract has not been previously published in whole or substantial part nor has it been presented previously at a national meeting.