Effect of non-surgical decompression in patients with lumbar herniated disk

Janković, Dragana; Cvjetković-Dragičević, Dragana; Stanković, Jelena

doi:10.5937/pomc16-18490

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PONS - medicinski časopis

2019, vol. 16, iss. 1, pp. 9-13

Effect of non-surgical decompression in patients with lumbar herniated disk

Janković Dragana, Cvjetković-Dragičević Dragana, Stanković Jelena

Zavod za fizikalnu medicinu i rehabilitaciju 'Dr Miroslav Zotović' Banja Luka, Republika Srpska, Bosna i Hercegovina

email: dragicevicdr@gmail.com

Keywords: intervertebral disc displacement; therapeutics; rehabilitation; traction; balneology

Abstract

Objective. Back pain caused by lumbar herniated disc has a great medical and socioeconomic significance. The question of optimal treatment of patients with a lumbar herniated disc is still controversial. The aim of this study is to examine the effect of intermittent lumbar spine traction on the functional status of these patients. Methods. A prospective study was followed by 90 patients with chronic back pain caused by lumbar discus hernias, both sexes, an average age of 48.26±11.60 years. Group A consisted of patients who performed ambulatory physical treatment without balneotherapy and intermittent lumbar traction. In group B patients had the same procedures like patients from group A, with balneotherapy but without intermittent traction, while in group C all patients had all of the above therapeutic modalities. All patients performed a ten-day rehabilitation treatment. Monitoring parameters were: VAS, Schober index and Oswestry index. Statistics analysis was done by SPSS version 19.0 by Wilcoxon-Mann-Whitney and Kruskal-Wallis test. Value of p>0.05 was considered as statistical significant. Results. There was no statistically significant difference in the indicated parameter between groups. An analysis of the parameters monitored in all three groups of patients found a statistically significant improvement over the baseline (p<0.05), but this difference between the groups did not reach statistical significance (p>0.05). Conclusion. The application of ten-day rehabilitation treatment, in the form of kinesiotherapy, electrotherapy and work therapy, is effective in patients with lumbar disc hernias. Reliable evidence of the superiority of lumbar application in relation to other applied rehabilitation interventions was not found.

Sažetak

Cilj. Bol u leđima uzrokovan lumbalnom diskus hernijom ima veliki medicinski i socioekonomski značaj. Kontroverzno je pitanje optimalnog tretmana ovih pacijenata. Cilj rada je ispitati efekat intermitentne trakcije lumbalne kičme na funkcionalni status pacijenata sa diskus hernijom. Metode. Prospektivnim istraživanjem je praćeno 90 pacijenata sa hroničnim bolom u leđima uzrokovanim lumbalnom diskus hernijom. Pacijenti su podijeljeni u tri grupe od po 30 pacijenata prema vrsti primijenjenih rehabilitacionih intervencija. Grupu A činili su pacijenti koji su provodili ambulantni fizikalni tretman (kineziterapija, elektroterapija i radna terapija) bez balneoterapije i intermitentne trakcije. U grupi B pacijenti su imali sve terapijske procedure kao i pacijenti iz grupe A uz balneoterapiju (hidroterapiju i peloid), ali bez intermitentne trakcije, dok su u grupi C svi pacijenti imali sve naprijed navedene terapijske modalitete. Svi pacijenti su provodili rehabilitacioni tretman jednom dnevno u trajanju od deset dana. Parametri praćenja ishoda rehabilitacije bili su: VAS bola, Schober indeks pokretljivosti lumbalne kičme i Oswestry indeks. U statističkoj analizi primijenjeni su Wilcoxon-Mann-Whitney i Kruskal-Wallis test. Rezultati. Ispitivani uzorak od 90 pacijenata činilo je 53,3% muškaraca i 46,7% žena prosječne starosti 48,26±11,60 godina. Kod sve tri grupe pacijenata na kraju rehabilitacijskog tretmana nađeno je visoko statistički značajno poboljšanje (p<0,05), ali ova razlika između grupa nije statistički značajna (p>0,05). Zaključak. Dokazani su pozitivni efekti provedenog desetodnevnog rehabilitacionog tretmana tokom kojeg je provođena kineziterapija, elektroterapija i radna terapija. Nisu nađeni pouzdani dokazi o superiornosti primjene lumbalne trakcije u odnosu na ostale primijenjene rehabilitacione intervencije.

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article language: Serbian
document type: Original Scientific Paper
DOI: 10.5937/pomc16-18490
published in SCIndeks: 14/02/2019

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