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

J Back Musculoskelet Rehabil. 2017 Sep 22;30(5):999-1004. doi: 10.3233/BMR-169546.

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; manipulative rehabilitation; post-operative disability; post-operative residual pain.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Diskectomy / rehabilitation*
  • Female
  • Follow-Up Studies
  • Humans
  • Lumbar Vertebrae / surgery*
  • Lumbosacral Region
  • Male
  • Middle Aged
  • Musculoskeletal Manipulations / statistics & numerical data*
  • Pain / surgery
  • Pain Measurement
  • Pilot Projects
  • Postoperative Period
  • Treatment Outcome