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Rehabilitation therapy after discectomy

Rehabilitation therapy after discectomy

15th April 2019

Discectomy is the surgical removal of the vertebral disc due to degeneration or herniation. In this process, a portion of the intervertebral disc that presses on a Nerve root, ganglion or the spinal cord is removed by surgery. Discectomy is indicated for radicular pain unresponsive to conservative management (e.g. analgesia and physiotherapy), neurological deficit (e.g. weakness) or for cauda equina syndrome. In all such cases, success after surgery depend on discectomy rehabilitation.

Quick Discectomy procedure recovery with discectomy rehabilitation

A lumbar discectomy procedure may also include a laminectomy. While discectomy involves cutting away the intervertebral disc portion, the laminectomy removes a section of the bone impinging on the nerves to alleviate the patient's trauma.  Post-operative care for quick discectomy procedure recovery depends on the efficient discectomy rehabilitation

Usually, discectomy rehabilitation begins immediately after surgery. The patient's movements are restricted and they are not allowed to bend, stretch or lift objects.  This is done to prevent a lumbar disc herniation as a consequence.  But unfortunately, due to the poor blood supply to the disc covering, hole of the extruded disc takes at least 3-4 months to heal. This time is too long to restrict the patient's activity. This is why surgeons advise discectomy rehabilitation immediately after surgery.

Moreover, clinical studies in the Spine journal reveal that even after early return to work, there was no risk of recurrent lumbar herniation.  Therefore, it has been clearly established that early mobilization after microdiscectomy actually helps patients heal sooner and for this to occur, discectomy rehabilitation is a must.

Microdiscectomy rehabilitation protocol

The main objective of microdiscectomy rehabilitation protocol is to help the patients regain their strength of the spine and range-of-motion through physical therapy and strengthening exercises.

Microdiscectomy rehabilitation protocol is structured in phases.

Phase 1- 0-2 weeks- Postural Education

Immediately after surgery, Phase 1 of the microdiscectomy rehabilitation protocol begins. This is the "Protective Phase" of discectomy rehabilitation where the patient is taught postural education and body mechanics. The aim of this phase is to correct the posture of the patient in an upright sitting mode with frequent lumbar rolls and changes in sleeping position.

Exercises include walking, light stretching, isometrics with multifidi and glute sets, transverse abdominal bracing etc.

Phase 2- 2-6 weeks- Initial Strengthening

Here the aim is to provide light strengthening to the spine and improve the patient's tolerance with 30 minutes of cardio per day. It also helps in releasing muscular spasms and soft tissue restrictions. On completion of this phase, the patient regains his/her independent body mechanics.

Here cardio exercises are initiated with walking progression and stationary bike workout. Light Strengthening exercises include transverse abdominis, glute activation and upper and lower extremity strengthening. Flexibility for the lumbar spine is with press-ups and stretching is with hip flexors, hamstrings and quadriceps. Aquatic physical training is also imparted for strengthening upper and lower extremities.

Phase 3- 6-8 weeks- Advanced Strengthening

This final phase of microdiscectomy rehabilitation protocol aims at providing advanced strengthening to enable the patient to return back to his/her normal routine of work and sport.
Patients are taught independent home exercises which they must continue to maintain spinal strength.

Patients can easily suffer a relapse and must be taught to look out for the warning signs and take remedial steps. Pain management is taught to the patient along with education on the signs of possible relapses

Patients are also advised avoid prolonged static positions or repetitive bending. The correct exercise equipment for elliptical, bike and terrain exercises is also recommended for further use.

Discectomy has become a relatively common procedure with lower back pain being the fourth highest cause of disability in India. Discectomy procedure recovery is swift and successful only when it is handled by the expert hands of a professional, competent and trusted rehabilitation centre in Chennai.

Diminish the discomfort after discectomy by reaching out to the best rehabilitation centre in Chennai for quick and lasting relief.