Outcome of Physiotherapy After Surgery for Cervical Disc Disease: a Prospective Multi-Centre Trial
Condition: Radiculopathy
MeSH terms: Radiculopathy
Study type: Interventional

Summary: 
      Many patients with cervical disc disease have long-lasting and complex symptoms with chronic
      pain, low levels of physical and psychological function and sick-leave. Surgery on a few
      segmental levels might be expected to solve the disc-specific pain but not the non-specific
      neck pain and the patients'illness. As much as 2/3 of the patients have been reported to have
      remaining physical/ psychological disability long-term after surgery. A structured
      physiotherapy programme after surgery may improve patients'function and return to work. The
      main purpose of the study is to evaluate what a well structured rehabilitation program adds
      to the customary treatment after surgery for radiculopathy due to cervical disc disease in
      respect to function, disability, workability and cost effectiveness. The study is a
      prospective randomised controlled multi-centre study, with an independent and blinded
      investigator comparing two alternatives of rehabilitation. 200 patients in working age, with
      cervical disc disease with clinical findings and symptoms of cervical nerve root compression
      will be included after informed consent. After inclusion in the study patients will be
      randomised to one out of the two alternatives of physiotherapy, (A) customary treatment
      (information/ advice on the specialist clinic) or (A+B) active physiotherapy; standardised
      and structured program of neck specific exercises combined with a behavioural approach plus
      customary treatment. Patients will be evaluated both clinically and with questionnaires
      before surgery, 6 weeks, 3 months, 6 months, 12 months and 24 months after surgery. Main
      outcome variable are neck specific disability. Cost-effectiveness will be calculated. The
      inclusion will preliminary be closed 2012. The study could contribute to a better clinical
      decision making, a better health care which will reduce physical, mental and social costs for
      the patients, and improve the rates of patients returning to and staying at work.
    


Intervention name(s): Customary treatment; Structured behavioural medicine program
Intervention type(s): Other; Other
Intervention description(s): The staff at the Neurosurgical clinic will give the patient ordinary pre- and postoperative information. The physiotherapist at the Neurosurgical clinic informs the patients what to avoid the first weeks after surgery and the importance of a good posture and ergonomic thinking in daily life. The patient is also instructed how to do exercises for the shoulder range of motion. Patients have ordinary post-surgery visit to the surgeon and to the physiotherapist about 6 weeks after the surgery, where physiotherapist instructs the patient in exercises for active neck range of motion.; The behavioural medicine program includes functional behavioural analysis of the problem, medical exercise therapy, strategies to increase self-efficacy in activities and problem-solving strategies for coping with disability.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Rehabilitation; Cervical Spine; Radiculopathy; Disc; Surgery