Objectifying performance assessments and personalized rehabilitation trajectories to improve return to work in failed back surgery patients.

01 October 2021 → 30 September 2025
Research Foundation - Flanders (FWO)
Research disciplines
  • Medical and health sciences
    • Health economy
    • Rehabilitation
    • Other paramedical sciences not elsewhere classified
Functional capacity Evaluation back pain return to work biopsychosocial approach
Project description

Treatment of Failed Back Surgery Syndrome (FBSS) is very complex. However, the incidence of patients that will develops FBSS after lumbar spinal surgery ranges from 10-40%, depending on the type of surgery. For therapy-refractory FBSS, meaning conservative treatment did not achieve adequate pain relief, Spinal Cord Stimulation (SCS) may serve as minimally invasive treatment. Despite the favourable results of a meta-analysis that SCS is an effective approach to stimulate return to work (RTW) and despite the beliefs of patients that RTW is a reachable goal after SCS treatment, less than 30% of patients implanted with SCS is returning to work. Therefore, it seems that current post-operative interventions, among which rehabilitation, are not effective for achieving RTW after SCS implantation in clinical practice. Therefore, within the current innovative project we propose a personalized biopsychosocial rehabilitation program specifically targeting RTW as the new treatment for patients implanted with SCS. This allows us to tackle the high burden of patients that are not re- entering the labour market by proceeding towards a multidisciplinary comprehensive evidence-based conservative intervention for a costly and debilitating condition. The objectives of the study are to examine if a personalized biopsychosocial rehabilitation program specifically targeting RTW is more effective than the usual care for improving the physical ability to work, increasing RTW rates, improving functioning in daily life and general quality of life and decreasing healthcare expenditure in FBSS patients after SCS implantation. In this project, 116 FBSS patients treated with SCS will be randomly divided in two groups (58 per group) namely the experimental intervention or the usual care program. Comparisons will be made for physical ability to work, work status and health care expenditure.