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The development of an evidence-based patient booklet for patients undergoing lumbar discectomy and un-instrumented decompression

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Abstract

Post-operative management after lumbar surgery is inconsistent leading to uncertainty amongst surgeons and patients about post-operative restrictions, reactivation, and return to work. This study aimed to review the evidence on post-operative management, with a view to developing evidence-based messages for a patient booklet on post-operative management after lumbar discectomy or un-instrumented decompression. A systematic literature search produced a best-evidence synthesis of information and advice on post-operative restrictions, activation, rehabilitation, and expectations about outcomes. Evidence statements were extracted and developed into patient-centred messages for an educational booklet. The draft text was evaluated by peer and patient review. The literature review found little evidence for post-operative activity restrictions, and a strong case for an early active approach to post-operative management. The booklet was built around key messages derived from the literature review and aimed to reduce uncertainty, promote positive beliefs, encourage early reactivation, and provide practical advice on self-management. Feedback from the evaluations were favourable from both review groups, suggesting that this evidence-based approach to management is acceptable and it has clinical potential.

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Acknowledgements

This study was conducted in line with the UK requirements on such studies and ethical approval was obtained for the patient evaluation of the booklets.

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Authors and Affiliations

  1. Biosurgery and Surgical Technology, Faculty of Medicine, Imperial College London, Charing Cross Hospital Campus, London, W6 8RF, UK

    A. H. McGregor

  2. Spinal Research Unit, University of Huddersfield, Huddersfield, UK

    A. K. Burton

  3. University of Leicester Hospitals NHS Trust and Queen’s Medical Centre Nottingham NHS Trust, Nottingham, UK

    P. Sell

  4. Unumprovident Centre for Psychosocial and Disability Research, University of Cardiff, Cardiff, UK

    G. Waddell

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  1. A. H. McGregor
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  2. A. K. Burton
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  3. P. Sell
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  4. G. Waddell
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Correspondence to A. H. McGregor.

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McGregor, A.H., Burton, A.K., Sell, P. et al. The development of an evidence-based patient booklet for patients undergoing lumbar discectomy and un-instrumented decompression. Eur Spine J 16, 339–346 (2007). https://doi.org/10.1007/s00586-006-0141-9

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  • DOI: https://doi.org/10.1007/s00586-006-0141-9

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