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

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


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.


herniated disc; epidural adhesiolysis; non-surgical treatment


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