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Back school or brain school for patients undergoing surgery for lumbar radiculopathy? A multi-center randomized controlled trial with two-year follow-up
Summary:
Scientific objectives: The primary scientific objective of the study entails examining whether perioperative pain neuroscience education (PPNE or ‘brain school’) is more effective than classical back school in reducing pain and improving pain inhibition in patients undergoing surgery for spinal radiculopathy. A secondary objective implies examining whether PPNE is more effective than classical back school in imparting a behavioural change (i.e. decreasing postoperative healthcare expenditure for lumbar radiculopathy), improving functioning in daily life and improving surgical experience (=better prepared for surgery, surgery meeting their expectations) in patients undergoing surgery for spinal radiculopathy.
Scientific approach: PPNE will be compared with classical back school in patients undergoing surgery for lumbar radiculopathy (n>100) in 3 Flemish hospitals. Hence, all patients will receive usual preoperative care plus surgery for lumbar radiculopathy. A double-blind randomized controlled trial with 2-year follow-up will be conducted, with pain and brain-orchestrated pain inhibition as primary outcome measures, and functioning, behaviour (i.e. postoperative healthcare expenditure) and surgical experience as secondary outcome measures. Psychological factors will be measured as possible treatment mediators. All baseline assessments will take place one week before surgery, and will be repeated as outcome assessments at day 5 following surgery and again at 6 weeks. Intermediate and long-term follow-up assessments will take place at 6, 12 and 24 months post-surgery.
Current project status: Currently, 90 patients undergoing surgery for spinal radiculopathy were included and were assessed before and approximately 5 days after receiving the PPNE or the classical back school. The intermediate follow-up assessment after 6 weeks has been performed in 88 patients. The long-term follow-up assessments have been performed after 6 months and 12 months in respectively 51 patients and 27 patients.
The protocol of this study is published in The Journal of Physiotherapy (1).
1. Ickmans K, Moens M, Putman K, Buyl R, Goudman L, Huysmans E, et al. Back school or brain school for patients undergoing surgery for lumbar radiculopathy? Protocol for a randomised, controlled trial. Journal of physiotherapy. 2016;62(3):165.