Rehabilitation Following Lumbar Disc Surgery

University of Utah60 enrolled

Overview

The proposed study will be a randomized clinical trial designed to determine the most effective physical therapy program for individuals who have undergone lumbar discectomy surgery. The study will compare two different post-operative physical therapy programs (general strengthening or general + specific strengthening). Both groups will begin treatment 2 weeks post-surgery. Subjects in both groups will receive weekly treatment sessions for 8 weeks with a treatment program emphasizing exercises shown to activate the large trunk muscles without imposing potentially harmful compression or shear forces. The general + specific strengthening group will also receive exercises shown to isolate activation of the deep trunk muscles, in particular the multifidus, with training augmented by the use of diagnostic ultrasound biofeedback. Patient assessments will be conducted pre- and post-surgery, as well as 10 (post-treatment) and 26 weeks after surgery.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Lumbar Disc Herniation Radiculopathy

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: * 18-60 years old * Diagnosis of LDH based on imaging (MRI or CT scan) of the lumbar spine with concurring clinical examination findings (based on the judgment of the attending neurosurgeon) * Appropriate surgical candidate based on the opinion of the attending spine surgeon, and scheduled for single-level lumbar discectomy (open or micro-discectomy). * Able to attend weekly treatment sessions. Exclusion Criteria: * Prior surgery to the lumbar spine * Spondylolytic or degenerative spondylolisthesis present on pre-surgical imaging * Unable to speak and understand English * Peri- or post-operative complication (infection, nerve injury, dural tear, vascular injury, etc.) that would limit or delay the ability to participate in post-operative rehabilitation. * Multi-level surgery or the use of instrumentation during surgery (i.e., lumbar fusion)

Outcomes

Primary Outcomes

Modified Oswestry disability index

Time frame: Preoperative, 2 postoperative weeks, 10 postoperative weeks, 6 postoperative months

Secondary Outcomes

Lumbar multifidus muscle activation as estimated by diagnostic ultrasound imaging

Time frame: preoperative, 2 postoperative weeks, 10 postoperative weeks, 6 postoperative months