Abstract
ObjectivesThe purpose of this study was to explore the effect of systematic lower-limb rehabilitation training in elderly patients undergoing lumbar fusion surgery due to serious degenerative intervertebral disc diseases.ResultsAt the 1st week after surgery, clinical rehabilitation effect in intervention group was better regarding lower-limb muscle strength, lower-limb DVT, VAS score, and ODI, as compared with control group (all p < 0.05). During the first two weeks after surgery, satisfaction rate in intervention group was higher than that in control group. However, there was no significant difference at last follow-up after surgery when comparing intervention group to control group.Materials and MethodsWe retrospectively collected medical records of elderly patients (aged ≥ 60 yrs) undergoing lumbar fusion surgery between 01/2013 and 01/2015 in our department. Some of the identified patients randomly underwent postoperative systematic training of lower-limb rehabilitation gymnastics (intervention group, n = 240), the others not (control group, n = 300). During postoperative period, intervention group received lower-limb rehabilitation gymnastics treatment for 3 months, but control group did not. All patients were routinely asked to return hospital for a check in the 1st postoperative week, as well as the 2nd week, the 1st month, and the 3rd month. Clinical outcomes were evaluated by scoring lower-limb muscle strength, detecting lower-limb deep venous thrombosis (DVT), visual analogue scale (VAS) score, lumbar JOA score, Oswestry disability index (ODI) questionnaire, and performing satisfaction survey.ConclusionsIn early postoperative stage, systematic lower-limb rehabilitation training can effectively speed up the recovery, beneficial to reducing lower-limb DVT and increasing patient satisfaction rate.
Highlights
Nowadays, lumbar fusion surgery is popular in treating degenerative disc diseases, especially for lumbar spinal diseases [1,2,3]
There was no significant difference at last follow-up after surgery when comparing intervention group to control group
Clinical outcomes were evaluated by scoring lower-limb muscle strength, detecting lower-limb deep venous thrombosis (DVT), visual analogue scale (VAS) score, lumbar Japanese Orthopaedic Association (JOA) score, Oswestry disability index (ODI) questionnaire, and performing satisfaction survey
Summary
Lumbar fusion surgery is popular in treating degenerative disc diseases, especially for lumbar spinal diseases [1,2,3]. Adults undergoing lumbar spine surgery have poorer physical and mental health outcomes compared to the general population [4,5,6]. Surgeons routinely recommend physical therapy to speed up rehabilitation after spine surgery. Postoperative www.impactjournals.com/oncotarget rehabilitation has been reported to improve outcome after disc surgery [10]. Some studies [1, 2, 11] reported that postoperative rehabilitation had no significant influence in pain and self-rated disability as compared to no treatment/self-management after lumbar surgery including lumbar disc herniation and spinal stenosis patients. Several randomized trials have found no significant difference between standard physical rehabilitation and either no treatment or an educational booklet [1, 2, 12]
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