Department of Neurosurgery, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey.
Eur Rev Med Pharmacol Sci. 2023 Oct;27(20):9521-9529. doi: 10.26355/eurrev_202310_34125.
Physical therapy and rehabilitation may improve low back pain and quality of life after lumbar disc herniation. However, there is no agreement on its optimal start time and rehabilitative methods. This study evaluates the effects of early and late rehabilitation on low back pain and quality of life following unilateral microdiscectomy.
A total of 204 patients who underwent surgery for lumbar disc herniation were included and subsequently randomized into five groups: 1. No exercise, 2. The 2nd-week walking group, 3. 1st-month walking group, 4. 2nd-week waist exercise, 5. 1st-month waist exercise. Visual analog scale (VAS) and Oswestry Disability Index (ODI) were assessed at the 1st week, 1st, 3rd, and 6th, and 12th-month follow-up after surgery.
1st-month VAS scores were analyzed, and a significant difference was found between the VAS scores of the 2nd-week walk (3.60±0.78) and 2nd-week waist exercise (3.38±0.67) groups and the other groups (p<0.001). 3rd-month VAS results were analyzed, and the VAS scores of the 1st-month walk group (2.67±0.48) were significantly higher than those of the 2nd-week walk group (1.73±0.45) (p<0.001). A significant difference was observed between the no-exercise group (2.93±0.91) and the other groups according to the 12-month VAS scores, with the VAS scores of the no-exercise group being significantly higher than the other groups (p<0.001). There was a significant difference between the ODI scores of both the 2nd-week walk (38±8.55) and the 2nd-week waist (33.8±6.61) exercise groups and the other groups according to the 1st-month ODI scores (p<0.001). A significant difference was observed between the no-exercise group (35.2±8.25) and the other groups according to the 12-month ODI scores, and the ODI scores of the no-exercise group were significantly higher than the other groups (p<0.001).
Regular exercise is highly recommended for long-term pain relief, as well as for achieving a speedy recovery after surgery, which is crucial to maintaining a high quality of life and preventing loss of earning potential. We believe that early implementation of exercises is ideal, but even if initiated later, standard back exercises can still expedite rehabilitation.
物理治疗和康复可能会改善腰椎间盘突出症后的腰痛和生活质量。然而，其最佳起始时间和康复方法尚无定论。本研究评估了单侧腰椎间盘切除术术后早期和晚期康复对腰痛和生活质量的影响。
共有 204 名接受腰椎间盘突出症手术的患者被纳入研究，并随后随机分为五组：1. 不运动，2. 术后第 2 周步行组，3. 术后第 1 个月步行组，4. 术后第 2 周腰部运动组，5. 术后第 1 个月腰部运动组。术后第 1 周、第 1 个月、第 3 个月、第 6 个月和第 12 个月分别评估视觉模拟量表（VAS）和 Oswestry 残疾指数（ODI）。
分析第 1 个月的 VAS 评分，发现第 2 周步行（3.60±0.78）和第 2 周腰部运动（3.38±0.67）组与其他组之间的 VAS 评分存在显著差异（p<0.001）。分析第 3 个月的 VAS 结果，发现第 1 个月步行组（2.67±0.48）的 VAS 评分显著高于第 2 周步行组（1.73±0.45）（p<0.001）。根据第 12 个月的 VAS 评分，无运动组（2.93±0.91）与其他组之间存在显著差异，无运动组的 VAS 评分明显高于其他组（p<0.001）。根据第 1 个月的 ODI 评分，第 2 周步行（38±8.55）和第 2 周腰部运动（33.8±6.61）组与其他组之间的 ODI 评分存在显著差异（p<0.001）。根据第 12 个月的 ODI 评分，无运动组（35.2±8.25）与其他组之间存在显著差异，无运动组的 ODI 评分明显高于其他组（p<0.001）。
我们强烈建议在手术后进行定期锻炼，以长期缓解疼痛，并促进术后快速康复，这对于维持高质量的生活和防止收入潜力损失至关重要。我们认为早期实施锻炼是理想的，但即使后期开始，标准的腰背锻炼仍然可以加快康复速度。
