presented by Adriaan Louw
Spinal surgery in the US is ever-increasing. Outcome data indicates nearly 40% of patients have persistent pain and disability following lumbar surgery. Postoperative rehabilitation following lumbar surgery has shown little efficacy in decreasing postoperative pain and disability and it has been shown that patients are not readily sent to physical therapy after lumbar surgery. Preoperative education has shown some effect in altering anxiety, stress and fear associated with surgery. Recent research in non-surgical musculoskeletal pain has shown evidence for neuroscience education. Neuroscience education aims to help patients develop a greater understanding of their pain, the biology behind their pain and how pain is processed. A newly designed preoperative neuroscience education program by physical therapists has recently been developed and have not only shown immediate post-education improvements in psychometric measures, beliefs and expectations for surgery and physical movements, but also significant reduction of brain activity associated with painful tasks in patients scheduled for lumbar surgery. Additionally, the preoperative neuroscience education resulted in superior outcomes following surgery compared to patients receiving traditional surgeon-led education in regards to back pain, leg pain, fear, catastrophization, function and postoperative healthcare utilization. This course aims to introduce attendees to the development of the preoperative neuroscience education session, the content, delivery methods and clinical application of such a program for lumbar surgery.
Adriaan, co-founder and CEO of ISPI, earned both an undergraduate as well as a master’s degree in research and spinal surgery rehabilitation from the University of Stellenbosch in Cape Town, South Africa. He is a guest lecturer/adjunct faculty at Rockhurst University, St. Ambrose University, and the University of Nevada, Las Vegas. In addition, he maintains a clinical practice and is co-owner of The Ortho Spine and Pain Clinic in Story City, Iowa. Adriaan has been teaching postgraduate, spinal manual therapy, and pain science classes throughout the US and internationally for 15 years. He is a Certified Spinal Manual Therapist through ISPI. In addition, Adriaan has presented at numerous national and international manual therapy, pain science, and medical conferences, and has authored and co-authored articles, books, and book chapters related to spinal disorders and pain science. Recently, Adriaan completed his Ph.D., which centers on therapeutic neuroscience education and spinal disorders.
Recognize various social and economic issues with the ever-increasing rates of low back surgery. Describe the outcomes of the most common low back surgeries as it pertains to pain and disability.
Recognize various issues related to low back surgery that lead to the development of a preoperative neuroscience educational program. Verify that various pain-related issues justify the need to develop a preoperative neuroscience educational program for lumbar surgery.
Master the content and delivery of the preoperative neuroscience educational program for patient undergoing lumbar surgery. Integrate the content and educational material from this section into clinical practice.
Recognize the various studies used to validate the results of the preoperative neuroscience educational program. Compare the preliminary results of the newly designed preoperative program to previous outcome studies for similar low back surgeries.
Verify why pain is complex and why surgery has such a relatively poor track record in easing pain. Identify various issues regarding pain that may result in a poor surgical outcome.