Work Ability After Anterior Cervical Decompression and Fusion Followed by a Structured Postoperative Rehabilitation: Secondary Outcomes of a Prospective Randomized Controlled Multi-Centre Trial with a 2-year Follow-up.
Anneli Peolsson, Johanna Wibault, Håkan Löfgren and 4 others
PMID 34894316WHAT IT FOUND
Adding structured postoperative rehabilitation did not improve work ability more than standard care two years after cervical fusion surgery.
Both groups improved similarly, suggesting recovery is driven by the surgery itself rather than the specific physiotherapy programme.
Key findings
01There was no significant difference in work ability improvement between the structured rehabilitation group and the standard care group at the 2-year follow-up.
02Work ability improved significantly from baseline to 2 years in both groups, with mean changes of 2.9 points (structured group) and 3.0 points (standard care) on the Work Ability Index.
03Patient expectations of being able to work within the next 6 months, measured at the 3-month follow-up, were the strongest predictor of work ability at 2 years.
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 trial was originally powered for the Neck Disability Index (NDI) as the primary outcome, not work ability, which may affect the sensitivity of the findings for this secondary outcome. The analysis excluded patients over 63 years old and those who underwent posterior surgery, limiting generalisability to the broader cervical spine surgery population. The standard care group was allowed to seek physiotherapy on their own, which may have diluted the differences between the two intervention arms.
Declared interests
The study was funded by Vetenskapsrådet (The Swedish Research Council) and Linköping University. No commercial conflicts of interest were declared.
The easy way to misread this
Do not conclude that postoperative rehabilitation is unnecessary. The null finding applies specifically to work ability outcomes; both groups improved, and the study does not rule out benefits of structured rehab for other outcomes like pain or physical function.