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Support Groups Support Recovery after Lumbar Fusion

There isn't a "best" rehabilitation program for lumbar spinal fusion patients. Different clinics use different programs. And none of the programs has been shown to work especially well. Two years after surgery, as many as 40 percent of lumbar fusion patients aren't much better.

These authors tested three different types of rehab programs for lumbar fusion patients. The 90 patients were divided into three groups. The training group had intense physical therapy twice a week for eight weeks. Therapy included muscle training, overall conditioning, and stretching. The video group watched a video of rehab exercises. They went through the exercises with a physical therapist one time. They were then told to exercise at home. The "back café" group did everything the video group did. But the back café group also met with a physical therapist and other lumbar fusion patients. The café groups met only three times over eight weeks. The meetings were casual. The group talked over a cup of coffee or tea about whatever subjects they wanted. They also got to ask the therapist questions.

All three groups were followed for two years. All groups were checked six months, one year, and two years after surgery. Researchers looked at back and leg pain, activities, and function. All three groups got better after surgery. And all three groups looked about the same early on.

However, two years later there were remarkable differences in the back café participants:

  • They had less pain.
  • They managed daily tasks better.
  • They were more likely to return to work.
  • They were generally more optimistic about their abilities.
  • They exercised more on their own.
  • They went to their doctors less often.

    The authors note that pain is hard to measure. People describe and handle pain in very different ways. The authors feel that the back café program may have helped people cope with their pain. The back café program was also the simplest and cheapest of the three programs. The authors feel the back café approach definitely deserves further research.


    Finn B. Christensen, MD, PhD, et al. Importance of the Back-Café Concept to Rehabilitation after Lumbar Spinal Fusion: A Randomized Clinical Study with a Two-Year Follow-Up. In Spine. December 1, 2003. Vol. 28. No. 23. Pp. 2561-2569.

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