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SA Orthopaedic Journal

On-line version ISSN 2309-8309
Print version ISSN 1681-150X

SA orthop. j. vol.7 n.2 Centurion Apr./Jun. 2008




Can active conservative intervention limit lumbar-spinal surgery?



PR EngelbrechtI; E CoetzeeII; J MennenIII; HP MeyerIV; J SnymanV; D KappVI; J du BuissonVII; IJJ GilauVII

IMB ChB (UOVS), MMed (Orth) (Pret), Orthopaedic Surgeon in private practice, Wilgers Hospital, Pretoria
IIMB ChB (Pret), MMed (Orth) (Pret) FCS (SA), Orthopaedic Surgeon in private practice, Pretoria East Hospital, Pretoria
IIIMB ChB (Pret), MMed (Neur.Chir) (Pret) FCS (SA), Neurosurgeon in private practice, Wilgers and Unitas Hospitals, Pretoria
IVMB ChB (Pret), MPraxMed (Pret), MFGP (SA), Professor, Department of Family Medicine, University of Pretoria
VMB ChB (Stell), MFAP (SA), M PraxMed (Pret), Medical advisor, Pretoria
VIMB ChB (Pret), Medical advisor, Pretoria
VIIMB ChB (Pret), MSc, BD (Toronto), Mphil, General Medical Practitioner, Pretoria
VIIIMB ChB (Pret), General Medical Practitioner, Pretoria





The objective of this study was to ascertain the effectiveness of an inter-disciplinary, cognitive and exercise-based active treatment programme to reduce the incidence of lumbar-spinal surgery. Patients were treated using internationally validated treatment protocols. A total of 234 patients, already advised to undergo lumbar-spinal surgery, were treated conservatively from 2005 until 2007. After an initial 6 weeks of active treatment, patients were put on a maintenance programme.
Nineteen patients required lumbar-spinal surgery.
The authors concluded that an active, inter-disciplinary and cognitive exercise-based treatment programme limited lumbar-spinal surgery to 8% in a case-controlled cohort of patients who had already been advised to undergo surgery.



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Dr PR Engelbrecht
Tel: (012) 807-1298/9; Fax: (012) 807-2639

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