Document Detail

Can spinal surgery be prevented by aggressive strengthening exercises? A prospective study of cervical and lumbar patients.
MedLine Citation:
PMID:  9915367     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine if patients recommended for spinal surgery can avoid the surgery through an aggressive strengthening program. SETTING: A privately owned clinic, staffed by physicians and physical therapists, that provides treatment for patients with neck and/or back pain. METHODS: Over a period of 2 1/2 years, consecutive patients referred to the clinic for evaluation and treatment were enrolled in the study if they (1) had a physician's recommendation for lumbar or cervical surgery, (2) had no medical condition preventing exercise, and (3) were willing to participate in the approximately 10-week outpatient program. Treatment consisted mainly of intensive, progressive resistance exercise of the isolated lumbar or cervical spine. Exercise was continued to failure, and patients were encouraged to work through their pain. Third-party payors in Minneapolis were surveyed for average costs. Average follow-up occurred 16 months after discharge. RESULTS: Forty-six of the 60 participants completed the program; 38 were available for follow-up and three required surgery after completing the program. DISCUSSION/CONCLUSIONS: Despite methodologic limitations, the results are intriguing. A large number of patients who had been told they needed surgery were able to avoid surgery in the short term by aggressive strengthening exercise. This study suggests the need to define precisely what constitutes "adequate conservative care."
B W Nelson; D M Carpenter; T E Dreisinger; M Mitchell; C E Kelly; J A Wegner
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  80     ISSN:  0003-9993     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  1999 Jan 
Date Detail:
Created Date:  1999-02-10     Completed Date:  1999-02-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  20-5     Citation Subset:  AIM; IM    
Physicians Neck and Back Clinic, Roseville, MN, USA.
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MeSH Terms
Back Pain / rehabilitation,  therapy*
Cervical Vertebrae
Costs and Cost Analysis
Exercise Therapy* / economics
Insurance, Health
Lumbar Vertebrae
Prospective Studies
Spinal Diseases / surgery,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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