Manipulative rehabilitation applied soon after lumbar disc surgery improves late post-operative functional disability: A preliminary 2-year follow-up study

Abstract

BACKGROUND

: Studies have shown late post-operative physical disability and residual pain in patients following lumbar disc surgery despite growing evidence of its beneficial effects. Therefore, rehabilitation is required to minimise the late post-operative complications.

OBJECTIVE:

To assess the feasibility of manipulative rehabilitation to improve late post-operative outcomes.

METHODS:

Twenty-one patients aged 25–65 years undergoing lumbar microdiscectomy were randomly assigned to the rehabilitation group ( $n=$ 14) or active control group ( $n=$ 7) by simple randomisation. Eight rehabilitation sessions were initiated 2–3 weeks after surgery. Thirty-minute sessions were conducted twice weekly for four weeks. Post-operative physical disability and pain were assessed at baseline and at the two-year follow-up.

RESULTS:

Post-operative physical disability improved more in patients who had undergone rehabilitation than in those who had received control care (63% vs. $-$ 23%, $P<$ 0.05). Post-operative residual low back and leg pain were alleviated in the treatment group (26% and 57%, respectively), but intensified in the control group ( $-$ 5% and $-$ 8%, respectively).

CONCLUSIONS:

This study demonstrated the potential of manipulative rehabilitation and importance of post-operative management after lumbar disc surgery. Definitive trials with larger sample sizes are required to confirm the feasibility and potential therapeutic effectiveness of this approach.