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Early comprehensive physiotherapy after lumbar spine surgery (PEDro synthesis)
  1. Gustavo C Machado1,
  2. Marina B Pinheiro2
  1. 1 School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
  2. 2 Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Dr Gustavo C Machado, School of Public Health, Sydney Medical School, The University of Sydney; gustavo.machado{at}

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Snowdon M, Peiris CL. Physiotherapy commenced within the first four weeks post-spinal surgery is safe and effective: a systematic review and meta-analysis. Arch Phys Med Rehabil 2016;97:292–301.


A small subgroup of patients with low back pain have significant neurological deficit or radicular syndrome secondary to lumbar disc herniation.1 Some patients opt for surgery without considering any conservative care, and for those whom conservative care does not bring relief, referral to surgery (such as discectomy) is common.2 However, many patients have persistent postoperative symptoms, including pain and reduced functional capacity.3 Early referral to physiotherapy is not routine practice, since surgeons typically place mobility restrictions for the first 6 weeks after surgery. However, there is evidence questioning this precautionary approach to postoperative care.4 Physiotherapy interventions could potentially improve outcomes soon after surgery,5 although it is still largely unknown whether early commencement of physiotherapy is safe and beneficial to patients after lumbar disc surgery.


The aim of the systematic review was to determine whether early comprehensive physiotherapy rehabilitation commenced within 4 weeks post lumbar disc surgery is safe and effective compared with a control group.

Searches and inclusion criteria

Electronic searches were conducted on Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Allied and Complementary Medicine Database (AMED), PubMed, …

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  • Twitter @gustavocmachado

  • Contributors GCM selected the systematic review and wrote the first draft of the manuscript. MBP contributed to interpretation of the data and revision of the final manuscript.

  • Funding GCM is supported by a grant from Sydney Health Partners.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.