Effect of Aggressive Rehabilitative Treatment on Canalicular Sequestered Lumbar Disc Herniations : Long-term Follow-up Study.

, Yang, Dong Seok; , Ahn, Sang Ho; , Lee, Dong Gyu; , Park, Kyung A; , Cho, Yun Woo; , Jang, Sung Ho; , Kim, Dong Gyu; , Kang, Jae Hoon; , Park, Hae Woon

Original Article

Journal of the Korean Academy of Rehabilitation Medicine 2006;30(6):584-589.

Yang, Dong Seok , Ahn, Sang Ho , Lee, Dong Gyu , Park, Kyung A , Cho, Yun Woo , Jang, Sung Ho , Kim, Dong Gyu , Kang, Jae Hoon , Park, Hae Woon

¹Department of Rehabilitation Medicine, Yeungnam University College of Medicine, Korea. hikkali@hanmail.net
²Department of Rehabilitation Medicine, The Catholic University of Daegu College of Medicine, Korea.

척추관 내 격리된 요추간판 탈출증의 적극적 재활치료 효과 - 장기 추적연구

양동석, 안상호, 이동규, 박경아, 조윤우, 장성호, 김동규, 강재훈, 박해운¹

영남대학교 의과대학 재활의학교실, ¹대구가톨릭대학교 의과대학 재활의학교실

Abstract

Objective
To assess long term outcomes of aggressive rehabilitative treatment on canalicular sequestered lumbar disc herniations
Method
Clinical outcomes of twenty four patients with sequestered disc herniation with symptomatic radicular pain were evaluated prospectively and longitudinally for one year. All patients received aggressive rehabilitative treatment including transforaminal epidural steroid injection, pelvic stabilization exercise, physical therapy, and back school. Clinical outcomes were measured by visual analogue scale (VAS) for back and radicular pain, Oswestry Disability Index (ODI) for back pain before treatment, posttreatment one, three, six, and twelve months. After twelve months, we categorized patients' satisfaction. Four patients were dropped out.
Results
The averages of VAS for lower extremity and back pain reduced significantly from 6.6 and 5.8 at pretreatment to 0.7 and 0.9 at 12 months posttreatment, respectively (p＜0.001). The averages of ODI reduced significantly from 73.5% at pretreatment to 22.3% at posttreatment 12 months (p＜0.001). Sixteen of twenty patients (80.0%) were satisfied with their current status posttreatment 12 months.
Conclusion
Sequestered disc herniations could be treated successfully by aggressive rehabilitative treatment. Clinical improvement was achieved from posttreatment one month and persisted for twelve months. Operation might be delayed until aggressive rehabilitation treatment fail to treat sequestered disc herniations. (J Korean Acad Rehab Med 2006; 30: 584-589)

Key Words: Lumbar disc herniation, Sequestration, Aggressive rehabilitation