Functional Recovery and Physiotherapy Compliance after Minimally Invasive Spine Surgery: A 1-year Retrospective Cohort Study
B. Mayuri Chandra, Naresh Kumar PagidimarriAbstract
Background:
Disorders of the cervical and lumbar spine, including radiculopathy, spinal stenosis, disc herniation, and degenerative disc degeneration, can result in severe impairment. Anterior cervical discectomy and fusion, endoscopic discectomy, and full endoscopic lumbar decompression are examples of minimally invasive spine surgeries (MISSs) that provide a quicker recovery and lower morbidity than open procedures. However, consistent postoperative physical therapy and routine follow-up are necessary for long-term results, for which Indian real-world data remain scarce.
Objectives:
The study aimed to track postoperative recovery at structured intervals from 10 days to 1 year and categorize outcomes based on symptom resolution, persistence, or recurrence while evaluating patient compliance with physiotherapy protocols across the follow-up timeline. In addition, the study aimed to identify patients requiring further clinical intervention and examine challenges in maintaining long-term follow-up and rehabilitation.
Materials and Methods:
Patients who had MISSs between February and June 2024 were included in this retrospective observational cohort study, which was carried out at a tertiary spine center in Hyderabad. Follow-up calls were made at 10 days, 1 month, 3 months, 4 months, 6 months, and 12 months.
Results:
The patients were divided into four categories: no follow-up, persistent, recurrent, and improved. There were three categories for physiotherapy adherence: noncompliant, partially compliant, and compliant. Frequencies, percentages, and graphical representations (line charts, bar graphs, and pie charts) were used in the descriptive analysis of the data. Improvement rates rose steadily, with half the patients achieving sustained recovery by 12 months. Physiotherapy compliance was highest early but declined after 3 months. Recurrence peaked at 12 months, mostly among partially compliant patients. Noncompliance was strongly linked to loss of follow-up, while full adherence predicted the best outcomes.
Conclusion:
MISSs combined with early structured physiotherapy, yields favorable 1-year outcomes. Sustained physiotherapy adherence is crucial for long-term recovery, highlighting the need for patient education, tele-rehabilitation, and structured follow-up systems.