Are Exercise and Physical Therapy Common Forms of Conservative Management in the Year Before Lumbar Spine Surgery?

Journal Article (Journal Article)

OBJECTIVE: To quantify and compare utilization of opioids, exercise therapy, and physical therapy in the year before spine surgery. DESIGN: A retrospective cohort of surgical and claims data. SETTING: Beneficiaries of the Military Health System seen at Brooke Army Medical Center PARTICIPANTS: Patients (N=411) undergoing surgery between January 1, 2014, and December 31, 2015, identified retrospectively through the Surgical Scheduling System (S3) based on procedure type (fusion, laminectomy, arthroplasty, vertebroplasty, and diskectomy). INTERVENTIONS: Elective lumbar spine surgery. MAIN OUTCOME MEASURES: Health care utilization variables present during the full 12 months before surgery, which included physical therapy services and visits for exercise therapy or manual therapy procedures and opioid prescriptions. RESULTS: The mean age of participants was 44.8±11.7 years and 32.4% were female. In the year before surgery, 143 (34.8%) patients had a physical therapy plan of care, 140 (34.1%) had at least 1 visit that included exercise therapy, and only 60 (14.6%) had a minimum of 6 exercise therapy visits. However, 347 (84.4%) patients received at least 1 opioid prescription fill (mean of 6.1 unique fills). CONCLUSIONS: Before elective lumbar spine surgery, opioid prescriptions were common but physical therapy services and exercise therapy utilization occurred infrequently.

Full Text

Duke Authors

Cited Authors

  • Carrignan, JA; Simmet, RT; Coddington, M; Gill, NW; Greenlee, TA; McCafferty, R; Rhon, DI

Published Date

  • August 2020

Published In

Volume / Issue

  • 101 / 8

Start / End Page

  • 1389 - 1395

PubMed ID

  • 32416147

Electronic International Standard Serial Number (EISSN)

  • 1532-821X

Digital Object Identifier (DOI)

  • 10.1016/j.apmr.2020.04.006


  • eng

Conference Location

  • United States