A Case of Juvenile Lumbar Disc Herniation with Postural and Gait Abnormality Successfully Treated by Post-operation Stretching

Abstract

We report a case of sufficient improvement of postural and gait abnormalities by surgery and additional postoperative meticulous rehabilitation in the patient with juvenile lumbar disc herniation. The patient was a 17-year-old boy with lumbar disc herniation at L4/5 level．In spite of conservative treatment for nine months, he began to show remarkable postural and gait abnormalities, such as forward bending posture with shortening of the iliopsoas muscle and knee joint flexion contracture. Microsurgical lumbar discectomy partially improved his symptoms, the residual symptoms were sufficiently improved by additional postoperative rehabilitation. To identify the causative muscles for the knee joint contracture and iliopsoas muscles shortening, trigger muscle identification test was performed. After the identification, muscles stretching was meticulously performed with satisfactory results. The significance of postoperative rehabilitation for patients with residual symptoms was confirmed in the present case. Herein, the clinical manifestation and postoperative rehabilitation are described in detail.