Manipulative rehabilitation applied soon after lumbar disc surgery improves late post-operative functional disability: A preliminary 2-year follow-up study

Article type: Research Article

Authors: Kim, Byungho J.^a | Kim, Taeyeong^a | Ahn, Junghoon^{a; b} | Cho, Heecheol^b | Kim, Dongyun^b | Yoon, Bumchul^{a; c; *}

Affiliations: [a] Department of Health Science, Graduate School of Korea University, Korea | [b] Department of Spinal Surgery, Seoul Chuck Hospital, Seoul, Korea | [c] Department of Physical Therapy, Korea University, Seoul, Korea

Correspondence: [*] Corresponding author: Bumchul Yoon, Department of Physical Therapy, College of Health Science, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul 136-701, Korea. Tel.: +82 2 3290 5684; Fax: +82 2 940 2879; E-mail: yoonbc@korea.ac.kr.

Abstract: BACKGROUND: Studies have shown late post-operative physical disability and residual pain in patients following lumbar disc surgery despite growing evidence of its beneficial effects. Therefore, rehabilitation is required to minimise the late post-operative complications. OBJECTIVE: To assess the feasibility of manipulative rehabilitation to improve late post-operative outcomes. METHODS:Twenty-one patients aged 25–65 years undergoing lumbar microdiscectomy were randomly assigned to the rehabilitation group (n= 14) or active control group (n= 7) by simple randomisation. Eight rehabilitation sessions were initiated 2–3 weeks after surgery. Thirty-minute sessions were conducted twice weekly for four weeks. Post-operative physical disability and pain were assessed at baseline and at the two-year follow-up. RESULTS: Post-operative physical disability improved more in patients who had undergone rehabilitation than in those who had received control care (63% vs. -23%, P< 0.05). Post-operative residual low back and leg pain were alleviated in the treatment group (26% and 57%, respectively), but intensified in the control group (-5% and -8%, respectively). CONCLUSIONS: This study demonstrated the potential of manipulative rehabilitation and importance of post-operative management after lumbar disc surgery. Definitive trials with larger sample sizes are required to confirm the feasibility and potential therapeutic effectiveness of this approach.

Keywords: Lumbar microdiscectomy, post-operative disability, post-operative residual pain, manipulative rehabilitation

DOI: 10.3233/BMR-169546

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 5, pp. 999-1004, 2017