Best practice rehabilitation pathway for the management of single and double-level lumbar fusion surgery: a modified Delphi Study.
Liedewij Bogaert, Tinne Thys, Bart Depreitere and 10 others
PMID 36988564WHAT IT FOUND
Experts agreed on 122 statements for lumbar fusion rehab, emphasizing early mobilization and a single contact person.
Patients validated this but highlighted a lack of relevant information and difficulty returning to work. This is expert consensus, not tested interventions.
Key findings
01A multidisciplinary panel of 31 experts reached consensus on 122 statements for a best-practice rehabilitation pathway covering the full continuum of care.
02Nine patients validated the expert consensus but reported a lack of relevant information and significant challenges with return-to-work, noting that less pain did not automatically improve function or well-being.
03The pathway identifies a need for a single contact person, especially in the first weeks post-operation, to address patient uncertainty and questions.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The results reflect expert opinion and patient perception, not the effectiveness of the proposed interventions. The study was limited to Belgium and the Netherlands, so findings may not transfer to other healthcare systems. Participation dropped in the final in-person round, though most consensus was reached in earlier rounds with higher response rates. The patient validation group was small (nine patients), which limits the generalizability of their specific experiences.
Declared interests
The authors declared no financial conflicts of interest. The research was funded by a grant from the Research Foundation – Flanders (FWO).
The easy way to misread this
Do not interpret this as evidence that the proposed pathway improves clinical outcomes. The study establishes expert consensus and patient agreement on what care should look like, but it does not test whether following this pathway reduces pain, disability, or surgery complications.