Postoperative functional exercise for patients who underwent percutaneous transforaminal endoscopic discectomy for lumbar disc herniation

摘要

OBJECTIVE: To explore the effects of postoperative functional exercise on patients who underwent percutaneous transforaminal endoscopic discectomy for lumbar disc herniation. PATIENTS AND METHODS: From January to May 2011, patients who had a lumbar disc herniation and then underwent percutaneous transforaminal endoscopic discectomy were divided randomly into two groups: the intervention group (n=46) and the control group (n=46). The intervention group conducted early functional exercises of passive and autonomic activities after their operations, while the control group conducted routine functional exercises after their operations. Short-term and long-term curative effects and quality of life were compared; risk factors that might affect the rehabilitation effects on the patients were analyzed using logistic regression. RESULTS: The lumbar curvature, lumbar lordosis index and sacral inclination angle of the intervention group were better than that those same spinal stability factors in the control group six months after their operations (p0.05). Scores for residual lumbocrural pain, straight leg raising, muscle strength (skin) sensory, nerve reflex and lumbar function of patients in the intervention group were better than those scores of the control group (p0.05). The scores for physiological function, emotional function, activity and social function, mental health and quality of life of the intervention group were better than those of the control group (p0.05). After 1 year of follow-up, the total effective rate for the intervention group was 82.6%, significantly higher than the control group, which had a total effective rate of 71.7% (p0.05). After 3 years of follow-up, the score for the intervention group was 97.8%, significantly higher than the control group, which had an overall average score of 89.1% (p0.05). Logistic regression analysis showed that the type of disc herniation, whether patients abided by their doctors’ advice during treatment and protected their lumbar vertebra during treatment, and their age were all influential factors on patient rehabilitation. CONCLUSIONS: Early functional exercises of passive and autonomic activities can improve the postoperative quality of life of patients with lumbar disc herniation and provides a basis for inclusion in postoperative treatment of lumbar disc herniation. Importance should be placed on factors, such as postoperative exercise, that can improve the curative effect of rehabilitation.