Evidence map›Paper›PMID 27807771›Full record

Trial reportEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2017

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

Christopher M Bono, Dana A Leonard, Thomas D Cha, Joseph H Schwab, Kirkham B Wood, Mitchel B Harris, Andrew J Schoenfeld

Abstract readComparative StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  18. Survey of lumbar discectomy practices: 10 years in the making.Journal of spine surgery (Hong Kong) · 2020
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  19. Two-year real-world results of lumbar discectomy with bone-anchored annular closure in patients at high risk of reherniation.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2019
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Christopher M BonoDepartment of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. bonocm@me.com.
Dana A LeonardDepartment of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Thomas D ChaDepartment of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
Joseph H SchwabDepartment of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
Kirkham B WoodDepartment of Orthopaedic Surgery, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA, 94304, USA.
Mitchel B HarrisDepartment of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Andrew J SchoenfeldDepartment of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe 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.

methodsThis 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.

resultsSix 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.

conclusionsThe 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.

Indexed as

Lumbar VertebraeAdultBack PainDiskectomyFemaleHumansIntervertebral Disc DisplacementMaleMiddle AgedPain MeasurementPostoperative CarePostoperative PeriodProspective StudiesRadiculopathyReturn to WorkLumbar discetomyPost-operative restrictionRandomized trialRehabilitationReherniation

Identifiers

PMID27807771

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.