How does back muscle strength change after posterior lumbar interbody fusion?

Abstract

<jats:sec> <jats:title>OBJECTIVE</jats:title> <jats:p>There is a lack of evidence of how back muscle strength changes after lumbar fusion surgery and how exercise influences these changes. The aim of this study was to evaluate changes in back muscle strength after posterior lumbar interbody fusion (PLIF) and to measure the effects of a postoperative exercise program on muscle strength and physical and mental health outcomes.</jats:p></jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>This prospective study enrolled 59 women (mean age 58 years) who underwent PLIF at 1 or 2 spinal levels. To assess the effects of a supervised lumbar stabilization exercise (LSE), the authors allocated the patients to an LSE (n = 26) or a control (n = 33) group. The patients in the LSE group performed the LSEs between 3 and 6 months postoperatively. Back extensor strength, visual analog scale (VAS) scores in back pain, and physical component summary (PCS) and mental component summary (MCS) scores on the 36-Item Short Form Health Survey were determined for the both groups.</jats:p></jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>Mean strength of the back muscles tended to slightly decrease by 7.5% from preoperatively to 3 months after PLIF (p = 0.145), but it significantly increased thereafter and was sustained until the last follow-up (38.1%, p &lt; 0.001). The mean back muscle strength was similar in the LSE and control groups preoperatively, but it increased significantly more in the LSE group (64.2%) than in the control group (21.7%) at the last follow-up 12 months after PLIF (p = 0.012). At the last follow-up, decreases in back pain VAS scores were more significant among LSE group patients, who had a pain reduction on average of 58.2%, than among control group patients (reduction of 26.1%) (p = 0.013). The patients in the LSE group also had greater improvement in both PCS (39.9% improvement) and MCS (20.7% improvement) scores than the patients in the control group (improvement of 18.0% and 1.1%, p = 0.042 and p = 0.035, respectively).</jats:p></jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>After PLIF, strength in back muscles decreased until 3 months postoperatively but significantly increased after that period. The patients who regularly underwent postoperative LSE had significantly improved back strength, less pain, and less functional disability at 12 months postoperatively.</jats:p></jats:sec>

Early Rehabilitation Program and Vitamin D Supplementation Improves Sensitivity of Balance and the Postural Control in Patients after Posterior Lumbar Interbody Fusion: A Randomized Trial

“…Most of the studies where the outcomes of rehabilitation were investigated were carried out between three and six months after surgery [4,33]. In this study, the supervised rehabilitation program, which started four weeks after surgery, required patients to make the effort to leave the house, drive a car, or use public transport in order to arrive at the university rehabilitation units.…”

“…During the early postoperative phase, therapeutic exercise has been suggested to keep the lumbar spine in a neutral position to minimize the strain on the fused segment. Moreover, therapeutic exercise programs are also required to stabilize the lumbar spine and lumbo-pelvic complex [1,4]. Thus, rehabilitation programs for patients are mainly focused on improving the weakness of muscles that occurs in the segments with a disc injury [4].…”

“…Moreover, therapeutic exercise programs are also required to stabilize the lumbar spine and lumbo-pelvic complex [1,4]. Thus, rehabilitation programs for patients are mainly focused on improving the weakness of muscles that occurs in the segments with a disc injury [4]. Lumbar stabilization exercise has been proven to eliminate local weakness and ameliorate movement control after any spinal surgical procedures [4].…”

Change in the Dimensions of the Lumbar Area Muscles after Surgery: MRI Analysis

“…The study group comprised 28 individuals (13 females and 15 males) who underwent a lumbar microdiscectomy in patients with lumbar disc herniation. We obtained the morphometric measurements of the lumbar area muscles at the L2-S1 level through the routine MRI performed for normal follow-up before surgery and at 6-12 months after surgery [13]. The control group comprised 37 individuals (18 females and 19 males) for whom retrospective archive images were available.…”

Letter to the Editor. Lumbar muscle strength changes after fusion: only due to rehabilitation exercises?

“…We read with interest the article by Lee et al 6 (Lee CS, Kang KC, Chung SS, et al: How does back muscle strength change after posterior lumbar interbody fusion? J Neurosurg Spine 26:163-170, February 2017).…”