DOI: https://doi.org/10.22141/1608-1706.4.20.2019.178755

Features of physical rehabilitation of patients with herniated discs who underwent epidural adhesiolysis

Ya.V. Fishchenko, I.V. Roy, L.D. Kravchuk

Abstract


Background. According to many authors, in 40–75 % of observations, low back pain is due to a disc-radicular conflict. 30–70 % of patients develop recurring exacerbations throughout the year, and 5–15 % of them require surgical treatment. But surgical treatment does not always solve the problem of reducing pain syndrome. Recently, the method of epidural adhesion has become increasingly popular. The purpose is to evaluate the effectiveness of physical exercises in the rehabilitation of patients with herniated discs undergoing epidural adhesiolysis. Materials and methods. We have analyzed data of 105 persons undergoing in-patient treatment at the department of rehabilitation of the Institute of Traumatology and Orthopaedics of the National Academy of Medical Sciences of Ukraine. The basic group (n = 55) of patients underwent a course of epidural adhesion and a program of physical rehabilitation. The control group (n = 50) received a course of epidural adhesiolysis procedures. Evaluation of pain syndrome was performed on the basis of visual analogue scale data. Oswestry Disability Index (ODI) was used to assess the degree of disability. Repeated observation was carried out 1, 3, 6 months after treatment. Results. The results of survey using ODI confirmed higher efficacy in the basic group by re-exa-mination in 6 months (23.0 ± 2.5 points, p < 0.05). The results of the re-examination in the control group according to ODI deteriorated (28.0 ± 2.8 points, p < 0.05). By results of visual analogue scale, there is a clear difference in the long-term treatment outcomes between the basic and the control group in 6 months — 2.9 ± 0.2 and 3.8 ± 0.4, respectively (p < 0.05). Conclusions. The systematic application of exercises combined with the procedure of epidural adhesiolysis allows increasing the efficiency of treatment in patients with hernias and protrusions of intervertebral discs in the stages of rehabilitation, which is confirmed by the results of the research.

Keywords


herniated disc; epidural adhesiolysis; non-surgical treatment

References


Hahne AJ, Ford JJ, McMeeken JM. Conservative management of lumbar disc herniation with associated radiculopathy: A systematic review. Spine (Phila Pa 1976). 2010; 35: 488-504.

Fischenko YV. Epiduralnyiy adgezioliz: opyit primeneniya u bolnyih s poyasnichnyim spinalnyim stenozom. VIsnik ortopediyi, travmatologiyi ta protezuvannya. 2014; 4: 36-41. [Ukraine]

Caspar W. A new surgical procedure for lumbar disc herniation causing less tissue damage through a microsurgical approach. Advances in Neurosurg. 1977. Vol.4: 74 – 77.http://dx.doi.org/10.1007/978-3-642-66578-3_15.

Miyagi M, Ishikawa T, Orita S, Eguchi Y, et al Disk injury in rats produces persistent increases in pain-related neuropeptides in dorsal root ganglia and spinal cord glia but only transient increases in inflammatory mediators: Pathomechanism of chronic diskogenic low back pain. Spine (PhilaPa 1976). 2011; 36: 2260- 66.

Carragee Е, Han PW, Suen М, Kim D. Clinical outcomes after discectomy for sciatica: The effects of fragment type and anular competence. Bone J Surg. Am. 2003; 85: 102-8.

Rutten S. Endoscopic lumbar disc surgery. Manual of Spine Surgery. Springler, Heidelberg, New York, Dordreccht, London.2012. 303р.http://dx.doi.org/10.1007/978-3- 642-22682-3_43.

Ahn Y, Lee S. Outcome predictors of percutaneous endoscopic lumbar discectomy and thermal annuloplasty for discogenic low back pain.ActaNeurochir. 2010; 152(10): 1695–1702.http://dx.doi.org/10.1007/s00701-010-0726-2

Racz GB, Heavner JE, Trescot A. Percutaneous lysis of epidural adhesions - evidence for safety and efficacy. 2008; 8: 277- 86.

Jamison DE, Hurley RW, Cohen SP.Frank Lee Epidural lysis of adhesions. Korean J. Pain. 2014; 1: 3–15.

Wang H, Huang B, Li C, Zhang Z, Wang J, Zheng W, Zhou Y. Learning curve for percutaneous endoscopic lumbar discectomy depending on the surgeon's training level of minimally invasive spine surgery. ClinNeurolNeurosurg. 2013 Oct;115(10):1987-91. doi: 10.1016/ j.clineuro.2013.06.008.

Rutten S, Komp M, Hanh P. Decompression of lumbar lateral spinal stenosis: full – endoscopic, interlaminar technique.Oper. Orthop. Traumatol. 2013. doi10.1007/s00064-012-0195-2.

Hirabayashi K, Miyakawa J, Satomi K. Operative results and postoperative progression of ossification among patients with ossification of cervical posterior longitudinal ligament. Spine. 1981; 6: 354 – 64. http://dx.doi.org/10.1097/00007632-198107000-00005.




Copyright (c) 2019 TRAUMA

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© Publishing House Zaslavsky, 1997-2019

 

   Seo анализ сайта