摘要
<b><span style="font-family:Verdana;">Background: </span></b><span style="font-family:Verdana;">Lumbar spinal stenosis (LSS)</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">continues to be a major problem in societies, causing job loss and lowering quality of life. There are two types of treatment methods, physical therapy and surgery. If patients with LSS avoid treatment, they are likely to experience neurological deterioration in later years.</span><b><span style="font-family:Verdana;"> Objective: </span></b><span style="font-family:Verdana;">The study aimed to evaluate the effect of physical therapy applied after decompression surgery or the effect of only applied physical therapy in patients with lumbar spinal stenosis. </span><b><span style="font-family:Verdana;">Materials and Methods: </span></b><span style="font-family:Verdana;">The results of the physical therapy follow-up of patients who had surgery and did not have surgery due to lumbar spinal stenosis between July 2014 and December 2019 were compared with each other. All patients received physical therapy</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">for 6 months. Included were 42 patients </span><span style="font-family:Verdana;">who </span><span style="font-family:Verdana;">underwent decompression surgery due to LSS</span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;"> 56 patients were not operated. Clinical outcomes were measured using the</span><span style="font-family:""> </span><span style="font-family:Verdana;">Nottingham Health Profile-Pain</span><span style="font-family:""> </span><span style="font-family:Verdana;">(NHP-Pain) scale at the</span><span style="font-family:""> </span><span style="font-family:Verdana;">initial, first, third and sixth</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">months. The results were compared statistically. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The age of the operated patients was 54.69 ± 8.42 (39</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">71), while the non-operated patients were 59.16 ± 14.04 (34</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">83). There was no significant difference in the statistical comparison (p = 0.053). While the body mass index</span><span style="font-family:""> </span><span style="font-family:Verdana;">(BMI)</span><span style="font-family:""> </span><span style="font-family:Verdana;">of the operated patients was 29.43 ± 4.99 (21</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">40), the BMI of the non-operated patients was 28.84 ± 4.62 (22</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">42). There was no significant difference in the statistical comparison (p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.552).</span><span style="font-family:""> </span><span style="font-family:Verdana;">The scores of a 6-month physical therapy follow-up of patients were evaluated according to the NHP-pain scale. The values of patients </span><span style="font-family:Verdana;">who </span><span style="font-family:Verdana;">underwent surgery, initial</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">1st month (p</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001), 1st month</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">3rd month (p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.028), 3rd month</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">6th month (p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.389) follow-up of the intervals were compared statistically.</span><span style="font-family:""> </span><span style="font-family:Verdana;">The values of non-operated patients, initial</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">1st month (p</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.008), 1st month</span><span style="font-family:""> </span><span style="font-family:Verdana;">-3rd month (p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.013), 3rd month</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">6th month (p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.025) were compared</span><span style="font-family:""> </span><span style="font-family:Verdana;">statistically. Patients with and without surgery had significantly different initial pain scores (p</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">< 0.001). </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">The NHP-Pain scores of the patients undergoing physical therapy with the operation were shown to provide more significant improvement than the group receiving only the physical therapy. Patients with LSS should be treated with an operation to obtain the maximum benefit of physical therapy.
<b><span style="font-family:Verdana;">Background: </span></b><span style="font-family:Verdana;">Lumbar spinal stenosis (LSS)</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">continues to be a major problem in societies, causing job loss and lowering quality of life. There are two types of treatment methods, physical therapy and surgery. If patients with LSS avoid treatment, they are likely to experience neurological deterioration in later years.</span><b><span style="font-family:Verdana;"> Objective: </span></b><span style="font-family:Verdana;">The study aimed to evaluate the effect of physical therapy applied after decompression surgery or the effect of only applied physical therapy in patients with lumbar spinal stenosis. </span><b><span style="font-family:Verdana;">Materials and Methods: </span></b><span style="font-family:Verdana;">The results of the physical therapy follow-up of patients who had surgery and did not have surgery due to lumbar spinal stenosis between July 2014 and December 2019 were compared with each other. All patients received physical therapy</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">for 6 months. Included were 42 patients </span><span style="font-family:Verdana;">who </span><span style="font-family:Verdana;">underwent decompression surgery due to LSS</span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;"> 56 patients were not operated. Clinical outcomes were measured using the</span><span style="font-family:""> </span><span style="font-family:Verdana;">Nottingham Health Profile-Pain</span><span style="font-family:""> </span><span style="font-family:Verdana;">(NHP-Pain) scale at the</span><span style="font-family:""> </span><span style="font-family:Verdana;">initial, first, third and sixth</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">months. The results were compared statistically. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The age of the operated patients was 54.69 ± 8.42 (39</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">71), while the non-operated patients were 59.16 ± 14.04 (34</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">83). There was no significant difference in the statistical comparison (p = 0.053). While the body mass index</span><span style="font-family:""> </span><span style="font-family:Verdana;">(BMI)</span><span style="font-family:""> </span><span style="font-family:Verdana;">of the operated patients was 29.43 ± 4.99 (21</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">40), the BMI of the non-operated patients was 28.84 ± 4.62 (22</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">42). There was no significant difference in the statistical comparison (p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.552).</span><span style="font-family:""> </span><span style="font-family:Verdana;">The scores of a 6-month physical therapy follow-up of patients were evaluated according to the NHP-pain scale. The values of patients </span><span style="font-family:Verdana;">who </span><span style="font-family:Verdana;">underwent surgery, initial</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">1st month (p</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001), 1st month</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">3rd month (p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.028), 3rd month</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">6th month (p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.389) follow-up of the intervals were compared statistically.</span><span style="font-family:""> </span><span style="font-family:Verdana;">The values of non-operated patients, initial</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">1st month (p</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.008), 1st month</span><span style="font-family:""> </span><span style="font-family:Verdana;">-3rd month (p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.013), 3rd month</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">6th month (p</span><span style="font-family:""> </span><span style="font-family:Verdana;">= 0.025) were compared</span><span style="font-family:""> </span><span style="font-family:Verdana;">statistically. Patients with and without surgery had significantly different initial pain scores (p</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">< 0.001). </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">The NHP-Pain scores of the patients undergoing physical therapy with the operation were shown to provide more significant improvement than the group receiving only the physical therapy. Patients with LSS should be treated with an operation to obtain the maximum benefit of physical therapy.
作者
Murat Baloğlu
Hüseyin Özevren
Murat Baloğlu;Hüseyin Özevren(Division of Physical Therapy and Rehabilitation, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey;Department of Neurosurgery, Medical School, Dicle Unviersity, Diyarbakır, Turkey)
