Application of Functional Exercise after Lumbar Disc Herniation Surgery
LIU Zhi-huan,WANG Xin,WU Hao-hua,CAO Hua-tuo
Department of Orthopedics, Yan' an People' s Hospital, Yan' an (71600), China
Abstract:
Objective To evaluate the timeliness of functional exercise after LDH surgery and its effect on lumbar function recovery. Methods Totally 100 patients accorded with the inclusion criteria were selected and randomly divided into treatment group and control group (n = 50 ). The patients in treatment group were given system lumbar dorsal and abdominal muscle function exercise after targeted percutaneous transforaminal endoscopic discectomy, and the patients in control group were given straight leg lift exercise and extensor moderate exercise after targeted percutaneous transforaminal endoscopic discectomy, follow-up of one year; the VAS and ODI scores were used for the ?rst day, 3 months, 6 months and 1 year after surgery. The number of lumbar back discomfort and lumbar stability were compared and analyzed after 1 year of operation. Results The VAS and ODI scores of the lumbar pain and leg pain were lower in both groups than before (P < 0 . 05). There was no statistically signi?cant difference between the two groups before and after 1 d of lumbar pain and leg pain VAS and ODI scores (P>0.05). The VAS score of lumbar pain in the treatment group was lower than that in the control group after 3 months [(1.31±0.42) vs (2.01±1.03)], 6 months [(0.67±0.32) vs (1.58±0.74)] and 1 year [(0.41±0.17) vs (1.37±0.64)] of operation (P<0.05). The VAS score of leg pain in the treatment group was lower than that in the control group at 3 months [(1. 31± 0.42) vs (2.01± 1. 03)], 6 months [(0.67± 0.32) vs (1.58±0. 74)] and 1 year [(0. 41± 0.17) vs (1.37±0. 64)] (P < 0. 05) after operation. The ODI score of the treatment group was lower than that of the control group at 3 months [( 10 . 14± 1 . 07 ) vs (12.33 ± 1 . 28 )], 6 months [( 8 . 21 ± 0 . 14 ) vs ( 10 . 34 ± 0 . 75 )] and 1 year [( 7 . 92 ± 0.05) vs (9.28 ± 0.42)] after operation (P < 0 . 05). After 1 year operation, the lumbar curvature, lordosis index and sacrum inclination angle of the two groups were significantly different from those before operation (P < 0 . 05 ). One year after operation, the lordosis index [(2.52±0.27) cm vs (2.32±0.58) cm], sacrum inclination angle [(31.08±4.81) ? vs (28.19±3.05)?] in the treatment group were all higher than those in the control group (P<0.05). There were statistically signi?cant differences compared with the control group in the anterior convex index and the oblique angle of the sacrum (P<0.05) of 1 year after operation. In the two groups, the positive rate of the lumbar leg was less than that after 1 year of surgery (P<0.05). Conclusion Targeted percutaneous transforaminal endoscopic discectomy for postoperative ef?cacy of LDH and the recovery of lumbar function can obviously alleviate the postoperative pain and discomfort, maintain the stability of the lumbar vertebra, reduce the recurrence rate, and the symptoms improve with the increase of the number of exercise times of the system.
