Event Title

The importance of providing patient education on pain mechanisms and pain ratings for 85 year old female patient status post lumbar spinal fusion surgery in an inpatient rehabilitation setting: A case report

Location

Hall of Governors

Start Date

7-4-2017 4:00 PM

End Date

7-4-2017 6:00 PM

Description

Background and Purpose: The purpose of this case report is to describe the physical therapy episode of care for a patient status post lumbar spinal fusion surgery in an inpatient rehabilitation hospital setting. The importance of patient education on pain, including limiting fear avoidance behaviors and the mechanisms of pain are discussed due to the patient presenting in extreme pain with numerous fear avoidance behaviors documented.

Case Description: The patient was an 85-year old Caucasian female who entered inpatient rehabilitation for a 14-day episode of care following a successful L2/L3 spinal laminectomy, interbody arthrodesis, and placement of interbody device resulting in fusion of the L2/L3 vertebra. The patient received extensive patient education along with traditional physical therapy exercises.

Outcomes: The patient successfully met all four goals established during the initial evaluation and was discharged home to continue therapy services. The patient was able to maintain spinal precautions, manage pain, transfer independently, and ambulate community distances using an assistive device.

Discussion: Current literature confirms the importance of limiting pain in order to increase the likelihood of a positive outcome following lumbar spinal fusion surgery. Not all patients require inpatient rehabilitation following lumbar spinal fusion surgery, and a contributing factor for this admission was pain. Self-limiting behaviors due to pain were documented and patient education was provided regarding rating the Numerical Pain Rating Scale (NPRS), mechanisms of pain, and fear-avoidance behaviors. While not a formal cognitive based therapy program, clinical judgment noted marked improvement once the patient was provided with this education.

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Apr 7th, 4:00 PM Apr 7th, 6:00 PM

The importance of providing patient education on pain mechanisms and pain ratings for 85 year old female patient status post lumbar spinal fusion surgery in an inpatient rehabilitation setting: A case report

Hall of Governors

Background and Purpose: The purpose of this case report is to describe the physical therapy episode of care for a patient status post lumbar spinal fusion surgery in an inpatient rehabilitation hospital setting. The importance of patient education on pain, including limiting fear avoidance behaviors and the mechanisms of pain are discussed due to the patient presenting in extreme pain with numerous fear avoidance behaviors documented.

Case Description: The patient was an 85-year old Caucasian female who entered inpatient rehabilitation for a 14-day episode of care following a successful L2/L3 spinal laminectomy, interbody arthrodesis, and placement of interbody device resulting in fusion of the L2/L3 vertebra. The patient received extensive patient education along with traditional physical therapy exercises.

Outcomes: The patient successfully met all four goals established during the initial evaluation and was discharged home to continue therapy services. The patient was able to maintain spinal precautions, manage pain, transfer independently, and ambulate community distances using an assistive device.

Discussion: Current literature confirms the importance of limiting pain in order to increase the likelihood of a positive outcome following lumbar spinal fusion surgery. Not all patients require inpatient rehabilitation following lumbar spinal fusion surgery, and a contributing factor for this admission was pain. Self-limiting behaviors due to pain were documented and patient education was provided regarding rating the Numerical Pain Rating Scale (NPRS), mechanisms of pain, and fear-avoidance behaviors. While not a formal cognitive based therapy program, clinical judgment noted marked improvement once the patient was provided with this education.