Rehabilitation of patients after lumbar microdiscectomy

Abstract

Objective: to investigate movement-based therapy (kinesitherapy) effectiveness in the rehabilitation of patients after lumbar microdiscectomy.Patients and methods. We enrolled 90 patients (33 men and 57 women, mean age — 59.78±12.0 years) after lumbar microdiscectomy due to the ineffectiveness of conservative management of discogenic lumbosacral radiculopathy. One-half of the participants (45 patients: 15 men and 30 women, mean age — 60.24±12.0 years) underwent kinesitherapy under the supervision of a physician; in other 45 patients (18 men and 27 women, mean age — 59.33±11.0 years), kinesitherapy was not included in the radiculopathy treatment protocol. We assessed pain intensity with visual analogue scale (VAS) and disability using the Roland-Morris scale (RMS) before surgery, ten days after the surgery, and 1, 3, and 6 months after surgery.Results and discussion. We observed a significant decrease in pain intensity - up to 4 points on the VAS, and an improvement in activities of daily living up to 10 points on the RMS 10 days after microdiscectomy. After six months, there was a decrease in pain intensity according to the VAS to 2 points in the kinesitherapy group and to 3 points in the group without kinesitherapy (p=0.088), as well as an improvement in activities of daily living according to RMS up to 5 points in the kinesitherapy group and up to 8 points in the group without kinesitherapy (p=0.003). Reoperations were required in two of 45 patients in the group without kinesitherapy (4.4%) and in one of 45 patients (2.2%) in the kinesitherapy group (p≥0.05).Conclusion. Kinesitherapy can improve functional recovery in patients after lumbar microdiscectomy.