Abstract
Purpose The purpose of this study is to investigate the clinical effect of lower-limb exercise, when combined with celecoxib, on pain management of patients undergoing posterior lumbar fusion surgeries. Methods The patients undergoing posterior lumbar fusion surgeries between 01/2018 and 06/2021 were retrospectively identified, with their data collected. After surgery, some patients took celecoxib for analgesia (celecoxib group, 200 mg/day) while the others took celecoxib together with lower-limb exercise (combined group, celecoxib-200 mg/day). On postoperative days (POD) 1, 3, 7, and 14, data were collected and analyzed regarding the following items: patient satisfaction, lower-limb muscle force, lumbar JOA score (29 points), Oswestry Disability Index (ODI), and visual analog scale (VAS) score. Results A total of 225 participants were included in this study. Specifically, 120 cases were admitted into in the celecoxib group and 105 were included in the combined group. Comparisons of baseline data did not indicate any difference between the combined group and the celecoxib group. Data analysis showed that patient satisfaction in the combined group was significantly higher than the celecoxib group on POD 3, 7, and 14, respectively (all p < 0.001). Moreover, the combined group had less VAS score compared with the celecoxib group on POD 3, 7, and 14, respectively (all p < 0.01). In addition, lower-limb muscle force in the combined group was significantly stronger than that in the celecoxib group on POD 3 and POD 7, respectively (both p < 0.01). Furthermore, the combined group achieved less ODI score than the celecoxib group on POD 3, 7, and 14, respectively (all p < 0.05). Comparisons of the lumbar JOA score did not suggest any statistical difference during the whole follow-up period. Conclusions In conclusion, postoperative lower-limb rehabilitation exercise can help to release pain after lumbar fusion surgeries. Additionally, postoperative lower-limb exercise can facilitate the recovery of lower-limb muscle force, as well as improving patient satisfaction.
Highlights
In clinical scenarios, lower back pain (LBP) mainly derives from intervertebral disc degeneration (IVDD) [1,2,3]
All participants were diagnosed with lumbar disc herniation or lumbar spinal stenosis. e related data were collected, including the data followed up with different time points on postoperative days (POD) 1, 3, 7, and 14
120 cases were admitted into the celecoxib group and 105 cases were included in the combined group. e combined group consists of 48 males and 57 females, while the celecoxib group consists of 54 males and 66 females. e median age of the combined group is 54 years, while the median age of the celecoxib group is 56 years
Summary
Lower back pain (LBP) mainly derives from intervertebral disc degeneration (IVDD) [1,2,3]. IVDD-related diseases, such as lumbar disc herniation, can lead to severe symptoms including LBP and lower-limb radicular pain. In such a situation, the patients usually need to undergo surgeries to remove the protruded disc and decompress the nerve root and spinal canal. Posterior lumbar interbody fusion surgery has been a widely used surgical procedure for treating IVDD-derived diseases, in particular, lumbar spinal diseases [4,5,6] It has been reported by previous studies that postoperative patients may experience prolonged LBP and low quality of life [7,8,9,10], that is one of the key reasons that some patients would seek physical therapy after lumbar fusion surgery, for a purpose of speeding up their rehabilitation
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