• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.10 no.2
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• pp.45-56
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• 2004

OBJECTIVE: The objective of this study was to know the effects of the postoperative lumbar extensor strengthening exercise program on back muscles strength and volume, pain, and the time of return to work. METHODS: A prospective controlled trial of lumbar extensor exercise program in patients who underwent microdiscectomy or percutaneous endoscopic discectomy for prolapsed lumbar intervertebral disc. Seventy-five patients were randomized into exercise group (20 male, 15 female) and non-exercise group (18 male, 22 female). Six weeks after surgery, patients in exercise group undertook a 12-week lumbar extension exercise (MedX) program. Assessment of spinal function was performed in all patients on postoperative 6 weeks, 18 weeks. The assessment included measures of lumbar extensor power, muscle mass of erector spinalis. All patients completed the visual analog scale (VAS) for evaluation of pain, and return to work. RESULTS: In muscle power, there were statistically significant improvements between pre and post test on muscle power in exercise group. But there were not statistically significant difference on muscle power in non-exercise group. In muscle mass, there were statistically significant difference between pre and post test on muscle mass in exercise group. But there were not statistically significant difference on muscle mass in non-exercise group. In the pain, there were statistically significant decrease between pre and post test on both group. But there were not statistically significant difference on fatty tissue and obesity in non-exercise group. The percentages of return to work in postoperative 4 months were significantly greater in the exercise group than in the non -exercise group. CONCLUSIONS: Postoperative lumbar extensor strengthening exercise program appears to be more beneficial to the patients who underwent operation for prolapsed lumbar intervertbral disc.

• Journal of Korean Neurosurgical Society
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• v.39 no.6
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• pp.413-418
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• 2006

Objective : The objective of this study is to evaluate and compare the clinical results between classical open surgery and percutaneous endoscopic lumbar discectomy[PELD] in cases of extraforaminal lumbar disc herniation. Methods : We obtained the clinical data from 47 patients with extraforaminal lumbar disc herniations who underwent the open paramedian muscle-splitting approach or percutaneous endoscopic lumbar discectomy[PELD] between January 2001 and February 2004. This study consisted of patients with soft disc extraforaminal herniations. The patients were assessed with the visual analogue scale[VAS] and MacNab's criteria before surgery, just before discharge, and postoperative 1 year. Results : There were 25 cases in the open surgery group and 22 cases in the PELD group. The average operating time was $78{\pm}36.71\;min$ in the PELD group and $110{\pm}29.68\;min$ in the open surgery group. The mean hospital stay was $2.73{\pm}2.62$ days in the PELD group and $7.68{\pm}2.59$ days in the open surgery group. VAS decreased from $8.34{\pm}0.66$ to $1.29{\pm}2.27$ in the PELD group and from $8.40{\pm}1.40$ to $1.70{\pm}1.72$ in the open surgery group at the one-year follow-up. The success rate of PELD was 86.4%, compared with 80.0% for open surgery. However, there were no statistically significant difference between two groups for success rate and VAS. Conclusion : Although the success rates were similar in both groups, PELD is less invasive, faster, and safe procedure than open surgery for extraforaminal disc herniation in selected patients.