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2017 ; 11
(4
): 531-537
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Prolonged Physiotherapy versus Early Surgical Intervention in Patients with
Lumbar Disk Herniation: Short-term Outcomes of Clinical Randomized Trial
#MMPMID28874970
Abou-Elroos DA
; El-Toukhy MAE
; Nageeb GS
; Dawood EA
; Abouhashem S
Asian Spine J
2017[Aug]; 11
(4
): 531-537
PMID28874970
show ga
STUDY DESIGN: Randomized controlled trial. PURPOSE: We compared the disability
and functional outcome after conservative treatment with prolonged physiotherapy
versus early surgical intervention in patients with lumbar disk herniation.
OVERVIEW OF LITERATURE: Lumbar disk herniation is one of the most common causes
of job-related disability in individuals less than 45 years old. Conservative
treatment is the initial pathway for the majority of patients but the duration of
conservative treatment remains debatable and the adverse effects of prolonged
conservative treatment are still unclear. Prolonged duration of symptoms before
surgical intervention is associated with worse outcomes than a short period of
symptoms. METHODS: From June 2011 to July 2013, 60 patients with lumbar disk
herniation at our institute were randomized into two groups. Group I was treated
with prolonged physiotherapy and rehabilitation for 6 months, while group II was
treated with early surgical discectomy. Oswestry disability index was used to
assess disability, while the Prolo economic outcome rating scale was used to
assess the work status. RESULTS: Most patients were males between 21 and 45 years
old (mean age, 35.88±7.15). There was significant improvement in the disability
and work status in both groups without statistically significant differences in
the disability score at the second or third assessment. However, the Prolo scale
became significantly better in group I than in group II patients during the
second and third assessments. CONCLUSIONS: A prolonged physiotherapy and
rehabilitation program is a beneficial and successful treatment in patients with
recently diagnosed lumbar disk herniation.