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Recovery of lumbar multifidus following spinal surgery for single level prolapsed intervertebral disc

Sparkes, Valerie, Laing, R. J. C., Bradley, M. and Prevost, A. T. 2003. Recovery of lumbar multifidus following spinal surgery for single level prolapsed intervertebral disc. Presented at: 14th International Congress of WCPT, World Physical Therapy 2003, Barcelona, Spain, 7-12 June 2003.

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Abstract

PURPOSE: The Lumbar multifidus muscle has been shown to provide a greater proportion of support in this region of the spine. Following a first episode of back pain the cross-sectional area of the muscle is reduced, the recovery of which is not automatic. During spinal surgery efforts are made to preserve the musculature, however in some cases there may be damage to the muscle and its nerve supply. This study aimed to measure the recovery of the lumbar multifidus muscle in patients after spinal surgery for lumbar disc prolapse. This study was part of a larger study identifying functional outcomes following spinal surgery for single level disc prolapse. RELEVANCE: This study will identify if the lumbar multifidus muscle recovers following spinal surgery for prolapsed intervertebral disc. SUBJECTS: 60 subjects who had undergone single level lumbar microdiscectomy or discectomy for disc prolapse were selected to the study. Patients previously trained in muscle stability exercises were excluded. METHODS AND MATERIALS: Prior to surgery the cross sectional area of lumbar multifidus, left and right side, at the level of the prolapse as confirmed on MRI, was measured using real-time ultrasound. Post operatively subjects were given the routine post-operative exercise programme, a general mobilising exercise programme. Subjects were reviewed at six weeks, 3 months and 6 months when repeated measurements of the lumbar multifidus were taken using real time ultrasound. ANALYSES: Comparisons of cross-sectional area of the multifidus muscle on the affected and unaffected side were analysed using mean percentage difference. RESULTS: The lumbar multifidus following surgery takes time to recover.In 56 cases at 6 months there was still asymmetry between sides. The mean percentage between side-difference at 6 months was 48 ± 18% (range 23-69%, P<0.001) . Further work in the larger study will identify if different exercise programmes have an effect on the recovery of the lumbar multifidus and restoration of function. CONCLUSIONS: The recovery of multifidus muscle following spinal surgery for disc prolapse surgery takes time and in most cases is not complete at 6 months. This has implications for rehabilitation programmes following spinal surgery for disc prolapse. Patients should be encouraged to continue their exercise programmes for at least 6 months after surgery.

Item Type: Conference or Workshop Item (Paper)
Date Type: Completion
Status: Unpublished
Schools: Healthcare Sciences
Subjects: R Medicine > RM Therapeutics. Pharmacology
Related URLs:
Last Modified: 04 Jun 2017 03:57
URI: http://orca.cf.ac.uk/id/eprint/29712

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