Oliveira João Pedro, Casqueiro Mariana, Andrade João Paulo, Reizinho Carla
Neurosurgery Department, Hospital de Egas Moniz, Unidade Local de Saúde Lisboa Ocidental, Portugal.
Department, Hospital da Luz, Lisbon, Portugal.
Brain Spine. 2025 Aug 6;5:104386. doi: 10.1016/j.bas.2025.104386. eCollection 2025.
Preoperative physical and psychological conditioning or 'prehabilitation', has emerged as a potential strategy to enhance surgical outcomes. While recent studies have investigated the role prehabilitation in spinal surgery, its specific role in lumbar disc herniation remains insufficiently defined.
To evaluate the impact of preoperative physical therapy/rehabilitation on postoperative outcomes and complications in patients undergoing surgery for lumbar disc herniation, compared to standard preoperative care. before surgery for lumbar disc herniation in the global outcome compared with the preoperative usual care in waiting list.
This systematic review searched 4 databases from January 2000 to March 2023. All studies (randomized clinical trials and observational studies) assessing the effects of prehabilitation in adult patients undergoing lumbar spine surgery, were eligible for inclusion. Five studies (n = 736) met inclusion criteria.
All included studies reported short-term improvements in pain, functional outcomes, and psychological readiness following prehabilitation. However, these benefits were not sustained at 6- or 12-months follow-up in most studies. Outcomes converged between intervention and control groups over time. One study highlighted that higher-intensity, supervised programs yielded greater early benefits than unsupervised protocols.
Prehabilitation appears to be a promising intervention for enhancing short-term recovery following lumbar spine surgery. Nevertheless, its long-term effectiveness remains uncertain. The current evidence is limited by clinical heterogeneity and lack of lumbar disc herniation specific trials. Future long-term, standardized, high-quality studies are essential to define its role in surgical outcomes.
术前身体和心理调节或“预康复”已成为一种改善手术效果的潜在策略。虽然最近的研究探讨了预康复在脊柱手术中的作用，但其在腰椎间盘突出症中的具体作用仍未明确界定。
与标准术前护理相比，评估术前物理治疗/康复对腰椎间盘突出症手术患者术后结果和并发症的影响。与术前常规护理相比，腰椎间盘突出症手术前的全球结果。
本系统评价检索了2000年1月至2023年3月的4个数据库。所有评估预康复对接受腰椎手术的成年患者影响的研究（随机临床试验和观察性研究）均符合纳入标准。五项研究（n = 736）符合纳入标准。
所有纳入研究均报告了预康复后疼痛、功能结果和心理准备方面的短期改善。然而，在大多数研究中，这些益处并未在6个月或12个月的随访中持续存在。随着时间的推移，干预组和对照组的结果趋于一致。一项研究强调，高强度、有监督的方案比无监督的方案产生更大的早期益处。
预康复似乎是一种有前途的干预措施，可促进腰椎手术后的短期恢复。然而，其长期有效性仍不确定。目前的证据受到临床异质性和缺乏腰椎间盘突出症特异性试验的限制。未来长期、标准化、高质量的研究对于确定其在手术结果中的作用至关重要。
