Does rehabilitation improve work participation in patients with chronic spinal pain after spinal surgery: a systematic review.

Objective: Patients with therapy-refractory chronic spinal pain after spinal surgery experience increased disability, resulting in substantial loss of employment and consequently lower quality of life. Despite findings that rehabilitation improves socio-economic outcomes in other chronic pain conditions, evidence for patients with chronic spinal pain after spinal surgery is limited. A systematic review was conducted to provide an overview of rehabilitation interventions and their effectiveness to improve work participation for patients with chronic spinal pain after spinal surgery.

Methods: MEDLINE (via PubMed), Scopus, Embase, and Web of Science, were systematically searched. Risk of bias was assessed using the modified Downs and Black checklist and GRADE was used to assess certainty of evidence. The review protocol was prospectively registered on PROSPERO (CRD42022346091).

Results: The search yielded 1,289 publications. Full-text screening of 48 articles resulted in the inclusion of 6 publications. The included interventions comprised multiple treatment components, consisting of back school, self-care, functional restoration, multidisciplinary rehabilitation, physiotherapy, and digital care programmes to improve work participation.

Conclusion: Rehabilitation to improve return to work for patients with chronic spinal pain after spinal surgery was supported only by low-certainty evidence. Rehabilitation therapies that are personalized and that integrate the patient's work seem most suitable.