J Korean Soc Spine Surg.  2002 Mar;9(1):41-47. 10.4184/jkss.2002.9.1.41.

Effects of the Strengthening Exercise on Back Muscles after Lumbar Discectomy

• Lee DH
• Shim DM
• Kim SS
• Ha DH
• Kim TK
• Kim YJ
• Song HH
• Kwon SH

• KMID: 1897089
• DOI: http://doi.org/10.4184/jkss.2002.9.1.41

Abstract

STUDY DESIGN: A retrospective study about lumbar strengthening exercise after lumbar discectomy.
OBJECTIVES
To evaluate the effect of lumbar strengthening exercise on muscle power and pain, to analyze the problem of rehabilitation program after lumbar discectomy. SUMMARY OF LITERATURE REVIEW: The effectiveness of Lumbar strengthening exercise is still controversy and we can not found the similar article for this kind problem.
MATERIALS AND METHODS
Three-hundred twenty eight patients of microscopic lumbar discectomy from 1998 to 1999, were divided into 2 groups; exercise group was 72 cases among 119 patients, and non-exercise group was 58 cases among 208 patients. degree of pain and functional activity were evaluated by visual analog scale and API test, respectively, at postoperative 3 months, 6 months, 1 year. the reason for not exercising was surveyed in non-exercise group.
RESULTS
Exercise group 119 patients(36%). The most common cause of Non-Exercise was a deficiency of importance for lumbar strengthening exercise and exercise was done better in civil peoples than inrural peoples. There was a significant good result in exercise group by visual analog scale for pain at 3 months and 6 months postoperatively, but no difference between two groups after 1 year. exercise group had better results in flexion/extension test and fatigue endurance test. Lumbar strengthening exercise was a good method for relieving the pain in short term, but it was not effective in long term follow up.
CONCLUSIONS
These results suggest that good results after lumbar discectomy in exercise group result from the secondary effects of increasing muscle power rather than relieving pain.

Keyword

lumbar discectomy; Back muscle; strengthening exercise

MeSH Terms

Back Muscles*
Diskectomy*
Fatigue
Follow-Up Studies
Humans
Rehabilitation
Retrospective Studies
Visual Analog Scale

Reference

1). Abramovitz JN, Neff S. Lumbar disc surgery: Results of the Prospective Lumbar Discectomy Study of the Joint Section on Disorders of the Spine and Peripheral Nerves of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons. Neurosurgery. 29:301–8. 1991.

2). Allaranta H, Hurme M, Karppi SL. Leisure time physi -cal activities and the results of surgery of lumbar disc herniation. Scand J Rehabil Med. 19:105–8. 1987.

3). Andrews DW, Lavyne MH. Retrospective analysis of microsurgical and standard lumbar discectomy. Spine. 15:329–35. 1990.

4). Barrios C, Ahmed M, Arrotegui J, Bjornsson A, Gill-strom P. Microsurgery versus standard removal of herniated lumbar disc. A three year comparison in 150 cases. Acta Orthop Scand. 65:399–405. 1990.

5). Berney J. S ciatiques chirurgicales et chiregie des scia -tique. Med Hyg. 38:2006–13. 1980.

6). Carpenter DM, Nelson BW. Low back strengthening for the prevention and treatment of low back pain. Med Sci Sports Exerc. 31:18–24. 1999.

7). Cassisi JE, Robinson ME, O’ conner P, MacMillan M. T runk strength and lumbar paraspinal muscle activity during isometric exercise in chronic low back pain patients and controls. Spine. 18:245–51. 1993.

8). Chatterjee s, Foy P, Findlay GF. Report of a controlled clinical trial comparing automated percutaneous lumbar discectomy and microdiscectomy in the treatment of contained lumbar disc protrusion. Spine. 20:734–8. 1995.

9). Dettori JR, Bullock SH, Sutlive TG, Franklin RJ, Patience T. T he effects of spinal flexion and extension exercises and their associated postures in patients with acute low back pain. Spine. 20:2303–12. 1995.

10). Donceel P, Du Bios M. Fitness for work after surgery for lumbar disc herniation: retrospective study. Eur Spine J. 17:29–35. 1998.

11). Dvorak J, Gauchat MH, Valach L. The outcome of surgery for lumbar disc herniation. I: A 4-17 years followup with emphasis on somatic aspects. Spine. 13:1418–22. 1988.

12). Faas A. Exercises: Which ones are worth trying, for which patients, and when ? Spine. 21:2974–79. 1996.

13). Gerad P, Brennan PT, Burry B, et al. The effects of aerobic exercise after lumbar microdiscetomy. Spine. 19:735–9. 1994.

14). Graves JE, Webb DC, Pollock ML, Matkozich J, Leggett SH, Carpenter DM, et al. Pelvic stabilization during resistance training: Its effect on the development of lumbar extension strength. Arch Phys Med Rehabil. 75:210–215. 1994.

15). Herron LD, Turner J. Patient selection for lumbar laminectomy and discectomy with a revised objective rating system. Clin orthop. 199:145–52. 1985.

16). Hirabayashi S, Kumano K, Ogawa Y, et al. microdiscectomy and 2nd operation lumbar disc herniation. Spine. 18:2206–11. 1993.

17). Hurme M, Alaranta H. Factors predicting the result of surgery for lumbar intervertebral disc herniation. Spine. 9:933–8. 1986.

18). Junge A, Frohlich M, Ahrens S, et al. Predictors of bad and good outcome of lumbar spine surgery: A prospective clinical study with 2 years follow up. Spine. 21:S1056–64. 1996.

19). Kotilainnen E. Microinvasive lumbar disc surgery: A study on patients treated with microdiscectomy or percutaneous nucleotomy for disc herniation. Ann Chir Gynaecol. 83:9–25. 1994.

20). Lavyne MH, Bilsky MH. Epidural steroids, postoperative morbidity and recovery in patients undergoing microsurgical discectomy. J Neurosurg. 77:90–5. 1992.

21). Long DM. D ecision making in lumbar disk disease. Clin neurosurg. 39:36–51. 1992.

22). Mattila M, Hurme M, Alaranta H, et al. The multifidus muscle in patients with lumbar disc herniation: A histo -chemical and morphometric analysis of intraoperative biopsies. Spine. 11:732–8. 1986.

23). McCulloch J. Microdiscectomy. Frymoyer JW, editor. ed.The Adult Spine. New York: Raven Press;1765-84. 1991.

24). Pollock ML, Leggett SH, Graves JE, Jones A, Fulton M, Cirulli J. Effect of resistance training on lumbar extension strength. Am J Sports Med. 17:624–9. 1989.

25). Risch SV, Norvell NK, Pollock ML, Risch ED, Langer H, Fulton M, et al. Lumbar strengthening in chronic low back pain patients: Physiologic and psychologic benefits. Spine. 18:232–238. 1993.

26). Rissanem A, Kalimo H, Alaranta H. Effect of intensive training on the isokinetic strength and structure of lumbar muscles in patients with chronic low back pain. Spine. 20:333–40. 1995.

27). Walker N. Langzeitverlaufe nach lumbaler Discushernien-Operation. Orthopaede. 8:211–4. 1979.