To investigate the effects of different rehabilitation intervention timing on symptom cluster relief after lumbar spine surgery, and provide scientific evidence for developing optimal postoperative rehabilitation strategies for lumbar spine surgery. A retrospective analysis was conducted on 223 patients who received lumbar spine surgery treatment in the Department of Spine Surgery of our hospital from January 2023 to December 2024. According to the timing of rehabilitation intervention, patients were divided into three groups: early rehabilitation group (starting from 1 day preoperatively to the day of surgery, n=75), conventional rehabilitation group (starting 3-7 days postoperatively, n=74), and delayed rehabilitation group (starting 8-14 days postoperatively, n=74). Visual Analogue Scale (VAS) was used to assess pain intensity, Oswestry Disability Index (ODI) and Japanese Orthopedic Association (JOA) lumbar spine disease evaluation and treatment score were used to assess functional status, Short Form-36 Health Survey (SF-36) was used to assess quality of life. The time to first ambulation, time to return to work, and complications within 30 days postoperatively were recorded. The baseline characteristics of the three groups were comparable (P>0.05). At 1 month and 6 months postoperatively, VAS scores in the early rehabilitation group were significantly lower than those in the conventional rehabilitation group and delayed rehabilitation group (P<0.05). At 6 months postoperatively, ODI scores: early rehabilitation group (18.3±6.9 points) was significantly lower than conventional rehabilitation group (24.7±8.1 points) and delayed rehabilitation group (30.5±9.8 points) (P<0.001). JOA improvement rate excellent rate: early rehabilitation group 76.0%, conventional rehabilitation group 44.6%, delayed rehabilitation group 21.6% (P<0.001). Time to first ambulation (20.8±5.2 hours) and time to return to work (8.4±2.1 weeks) in the early rehabilitation group were significantly shorter than the other two groups (P<0.001). At 6 months postoperatively, SF-36 scores in all dimensions in the early rehabilitation group were significantly higher than the other two groups (P<0.05). Complication rate within 30 days postoperatively: early rehabilitation group 1.3%, conventional rehabilitation group 5.4%, delayed rehabilitation group 8.1% (P=0.157). Early rehabilitation intervention (starting from 1 day preoperatively to the day of surgery) can significantly improve pain symptoms, functional status, and quality of life in patients after lumbar spine surgery, shorten functional recovery time, and reduce complication rates. It represents the optimal rehabilitation intervention strategy after lumbar spine surgery. However, while the ODI functional improvement (12.2 points) exceeds the minimal clinically important difference (MCID) of 10 points, the VAS pain reduction between groups (1.2 points) falls below the MCID threshold of 1.5-2.0 points, suggesting functional improvement rather than pain reduction represents the primary clinical benefit.
Shi et al. (Tue,) studied this question.