Effective rehabilitation following lumbar spinal surgery

We aim to improve and evaluate the clinical effectiveness of the rehabilitation of patients following lumbar spinal surgery.


  • Post primary lumbar discectomy
  • Post primary lumbar spinal fusion

Our management of pain and disability originating from the lumbar spine has improved over the years.

  • We are much clearer on what treatments are valuable
  • We are improving in our targeting of  different treatments to individual patients

Some patients are managed through spinal surgery that includes lumbar discectomy and lumbar spinal fusion surgical procedures.

Physiotherapy to enable return to full physical activity and social function is important.

Post-operative rehabilitation is a key issues to prevent ongoing symptoms and disability and to enable patients to make an optimal recovery. Different patients have different needs.

We are investigated a stepped care approach following lumbar discectomy

  • Step 1 is a surgery specific leaflet
  • Step 2 is individual outpatient physiotherapy
  • Step 3 is an active return to work / function programme

We are developing a tool that can be used following lumbar spinal fusion surgery to inform:

  • Which patients require physiotherapy
  • What specific physiotherapy intervention they need

What are the outcomes of this research?

Randomised controlled trial investigating the effectiveness and cost-effectiveness of a stepped care physiotherapy intervention following primary lumbar discectomy (external pilot and feasibility trial complete).

Following a systematic review of prognostic factors and a cohort study investigating potential prognostic factors, a screening tool will be developed and evaluated in a randomised controlled trial investigating effectiveness and cost-effectiveness of rehabilitation.

People involved

Chief Investigator:

Alison Rushton

Co Investigators Discectomy:

Nicola Heneghan

Peter Goodwin 

Melanie Calvert 

Co Investigators Fusion:

Bart Staal, Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, The Netherlands

Paul Willems 

Martin Verra 

Nicola Heneghan