The problem of adipose degeneration of the paraspinal muscles in patients after surgery for degenerative stenosis

Abstract

Degeneration of the multifidus muscle of the back after stabilizing operations on the lumbar spine and its impact on rehabilitation measures remains understudied. There are isolated data in publications on the partial effectiveness of minimally invasive surgery, but the problem has not been completely solved, there is no data on the effect of physical therapy and physiotherapy methods on the progress of degeneration of the multifidus muscle of the back. Purpose To study the effect of electroneuromyostimulation and physical therapy in the postoperative period in decompression-stabilizing operations on the progress of adipose degeneration of the multifidus muscle of the back. Materials and methods The parameters of the multifidus muscle of the back were analyzed and determined in 3 groups of patients who underwent operations with stabilizing systems in the lumbar spine: in group I (n = 56), it was recommended to limit physical activity for 2 months after surgery and wear a semi-rigid corset; in group II (n = 41), early rehabilitation was initiated in the form of physical therapy with the continuation of the recommended exercises after discharge, in group III (n = 43), patients after discharge were recommended to limit physical activity, but with the use of electroneuromyostimulation on the paravertebral muscles 2 times a day lasting 15–30 minutes. All patients underwent clinical examination, MRI, MSCT to assess the condition of the multifidus muscle. Results In group II, there was a decrease in the rate of adipose degeneration of the multifidus muscle, but with increase in pain and decrease in life quality compared to group I. Patients of group III had the lowest rate of increase in adipose degeneration with less pain and a higher level of life quality compared to groups II and I. Conclusions A combination of early postoperative stimulation for two months with a subsequent transition to physical therapy is optimal; otherwise exceeding the functional threshold may cause disruption of adaptation systems.

Effects of Various Rehabilitations on Pain and Performance of Elite Athletes Who Return to Play after Lumbar Disc Herniation

“…In Part I (5-14 days after surgical intervention): light warm-up (10 min); knee extension while lying supine with the spine in a neutral position and the hip flexed to a 90° angle ( Russian physicians & sport professionals presented information about the possibility of successful rehabilitation of professional athletes after operative treatment of LDH, with helping of 8-weeks electroneuromyostimulation therapy with simultaneous restriction of motor activity for involve decrease of stress forces at the back [29]. Also, physicians reported that combination of early postoperative stimulation (electroneuromyostimulation) and restriction of motor activity for 2 months with a subsequent transition to physical therapy is optimal for patients with operative treatment of lumbar spine [30]. Physicians reported on the high efficiency of the course of electroneuromyostimulation therapy for patients with back pain, including LBP and LDH [13,15,29,31].…”