Cognitive-Behavioral-Based Physical Therapy for Patients with Severe Lumbar Spinal Stenosis: A Report of 38 Cases

The aim of this study was to perform a follow-up of patients of lumbar spinal stenosis (LSS) with severe stenosis (narrowing of more than two-thirds/MRI axial T2) who received cognitive-behavioral-based physical therapy (CBPT) in our clinic.

From January 2019 through June 2019, 255 cases of history of LSS came to our clinic. Cases with fracture of vertebral body et al. were excluded.

Finally, 38 cases with severe stenosis were selected.

Among these 38 patients with severe LSS, 26 (68%) patients came back to our clinic for other reasons (neck pain etc.) and were free of LSS-related symptoms. On the other hand, 12 (32%) came back with LSS-related symptoms. Among these, 11 patients underwent CBPT again with good result. Revision of the decision not to operate occurred in 1 case. Our study depicted the important aspect of good natural history of LSS patients with severe stenosis under CBPT program.

In CBPT program we set 3 phases of treatment which is acute phase, subacute phase and chronic phase. Exercise should be individualized in each phase.

The details of CBPT which have rarely been reported are discussed. 

Keywords: lumbar spinal stenosis (LSS), cognitive-behavioral-based physical therapy (CBPT), 3 phases of treatment.