Liang Xiao, Wang Yexin, Yue Yaosheng, Li Yanpeng, Meng Chunyang
Affiliated Hospital of Jining Medical University, Jining, China.
Jiaxiang Peaple's Hospital, Jining, China.
Front Surg. 2022 May 9;9:860140. doi: 10.3389/fsurg.2022.860140. eCollection 2022.
To detect the influences of postoperative out-of-bed activity restriction on recurrence rate, low back and leg pain, functional rehabilitation after percutaneous endoscopic lumbar discectomy (PELD).
In this research, 213 patients with lumbar intervertebral disc herniation (LDH) who underwent PELD were divided into the out-of-bed activity restriction group and out-of-bed activity non-restriction group. The visual analog scale (VAS) and Oswestry disability index (ODI) scores were used to evaluate postoperative clinical efficacy at 1 and 3 months after the operation, and to count the recurrence rates. All of these operations were performed between August 2017 and July 2020, and they were followed in the outpatient department for 12 months at least.
Both of the groups showed significantly lower VAS and higher ODI scores at 1 month and 3 months post-operation, respectively, when compared with pre-operation. At 1 month after the operation, the restriction group performed lower VAS scores of low back pain compared with the non-restriction group, but this advantage disappeared at 3months post-operation. However, there was no statistical difference in the VAS scores of leg pain and ODI scores between the two groups, neither at 1 nor 3 months after the surgery. The recurrence rate is significantly lower in the restriction group than in the non-restriction group at a 12-month follow-up after the surgery.
Out-of-bed activity restriction in the early postoperative period of PELD could reduce LDH recurrence effectively, and it may relieve the low back pain to some extent. It has no benefit in the recovery of leg pain and functional rehabilitation.
探讨经皮内镜下腰椎间盘切除术(PELD)术后限制下床活动对复发率、腰腿痛及功能康复的影响。
本研究将213例行PELD的腰椎间盘突出症(LDH)患者分为下床活动限制组和下床活动非限制组。采用视觉模拟评分法(VAS)和Oswestry功能障碍指数(ODI)评估术后1个月和3个月的临床疗效,并计算复发率。所有手术均在2017年8月至2020年7月期间进行,术后至少在门诊随访12个月。
与术前相比,两组患者术后1个月和3个月的VAS评分均显著降低,ODI评分均显著升高。术后1个月,限制组的腰痛VAS评分低于非限制组,但术后3个月该优势消失。然而,两组患者术后1个月和3个月的腿痛VAS评分及ODI评分均无统计学差异。术后12个月随访时,限制组的复发率显著低于非限制组。
PELD术后早期限制下床活动可有效降低LDH复发率,并在一定程度上缓解腰痛。对腿痛恢复及功能康复无益处。