Lower Extremity Motor Function 1-year Following Surgical Management of Lumbar Disc Herniation

Shay Menachem Alon Rabin Oded Hershkovich Alon Friedlander
Orthopaedic Department, The Sheba Medical Center, Tel Hashomer, Israel

introduction: approximately 25% of the patients who undergo surgical treatment for lumbar disc herniation experience lower extremity weakness 1 year after surgery.

in common practice as in the literature assessment of strength is limited to the various myotomes.

in addition, the assessment is qualitative rather than quantitative and is done manually with low sensitivity to minor differences.

the aim of this study was to assess the muscular function of the limb using objective tests for muscle strength and endurance in patients 1 year following surgical treatment for lumbar herniated disc.

materials and methods: Patients were examined 1 year following the surgical treatment in our institute outpatient clinic.

the patients were asked to fill the pain magnitude questionnaire and the oswestry disability index and underwent a series of physical examinations including: sensory deficit, motor function (myotomes), reflexes, SLR and slump test, flexion and extension of the spine and functional tests.

results: the mean ODI score was 26 at 1 year following the surgical treatment.

the mean NPRS was 2.78 (out of 10) .

the mean angle of range of extension of the spine was 19 degrees with max value of 25 degrees compared to 35-40 degrees in healthy individuals . the values of the uninvolved limb were higher in the dynamometer (stronger) than on the involved limb but the differences between those values were not significant statistically.

Significant correlation was found between the NPRS and ODI values to the range of extension of the lumbar spine on physical examination.

conclusions: No difference in limb function 1 year following surgical treatment for lumber disc herniation.

reduced lumbar spine range of motion for extension is correlated with higher score on ODI and NPRS