Does rehabilitation improve work participation in patients with chronic spinal pain after spinal surgery: a systematic review.

Only 6 studies were included, and the review used narrative synthesis because heterogeneity and limited numbers prevented meta-analysis. Patients with previous spinal surgery were a minority subgroup in mixed study populations, comprising 10% to 30% of participants. Several observational studies were scored as poor, two as fair, and the randomized controlled trial as good but with blinding concerns. Missing data and loss to follow-up were reported in several studies. Only four of six studies reported employment status before and after intervention. Included studies varied in setting, duration, intensity, team composition, and comparators. Five mixed-population studies were excluded because subgroup work outcomes could not be obtained. The review searched only English, French, Dutch, and German literature.

The authors report no specific grant from public, commercial, or non-for-profit funding agencies. No other conflicts of interest are stated.

Do not conclude that rehabilitation reliably improves work participation after spinal surgery. The positive return-to-work rates came from one comparison against no treatment, the study by Cui et al. found no employment change, and the review states there is not enough evidence for recommendations.