Early individualised manipulative rehabilitation following lumbar open laser microdiscectomy improves early post-operative functional disability: A randomized, controlled pilot study

Article type: Research Article

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

Affiliations: [a] Department of Health Science, Graduate School of Korea University, Seoul, 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, 161 Jeongneung-ro, Seongbuk-gu, Seoul 136-703, Korea. Tel.: +82 2 940 2833; Fax: +82 2 940 2879; E-mail:[email protected]

Abstract: BACKGROUND: Lumbar open laser microdiscectomy has been shown to be an effective intervention and safe approach for lumbar disc prolapse. However early post-operative physical disability affecting daily activities have been sporadically reported. OBJECTIVE: To evaluate the feasibility of using early individualised manipulative rehabilitation to improve early post-operative functional disability following lumbar discectomy. METHODS: Randomised controlled pilot trial. Setting at a major metropolitan spine surgery hospital. Twenty-one patients aged 25-69 years who underwent lumbar microdiscectomy were randomised to either the manipulative rehabilitation treatment group or the active control group. Rehabilitation was initiated 2-3 weeks after surgery, twice a week for 4 weeks. Each session was for 30 minutes. Primary outcomes were the Roland-Morris disability questionnaire and the visual analogue pain scale. Outcome measures were assessed at baseline and post-intervention. RESULTS: Early post-operative physical disability was improved with a 55% reduction by early individualised manipulative rehabilitation, compared to that of control care with a 5% increase. Early post-operative residual leg pain decreased with rehabilitation (55%) and control care (9%). CONCLUSION: This pilot study supports the feasibility of a future definitive randomised control trial and indicates this type of rehabilitation may be an important option for post-operative management after spinal surgery.

Keywords: Lumbar disc surgery, micro-discectomy, early post-operative disability, early post-operative residual pain, manipulative treatment, rehabilitation

DOI: 10.3233/BMR-150591

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 29, no. 1, pp. 23-29, 2016