| ?Objective? Prolapse of lumbar intervertebral disc is a kind of syndrome common to departments of orthopedics.Its pathogenesis is that hernia of nucleus pulposus,which caused by lumbar DD,stimulates and compresses nerve root and cauda equine.Prolapse of lumbar intervertebral disc is the most common cause of lumbocrural pain.It is most often diagnosed in people in their thirties to fifties and showed younger trend.About 10%~80% patients with prolapse of lumbar intervertebral disc eventually necessitate operations,and surgical treatment is widely acknowledged.However,with the increasing number of surgeries,the operation complications have drawn more surgeons' attention.Surgeons start to focus on enhanced recovery after surgery(ERAS).ERAS,also called fast-track surgery,is the combination of a series of important preioperative period treatment.Many researches have confirmed that early rehabilitation training after the surgery is one of effective ways to relieve low back pain,functional limitation of lumbar vertebra and weakness in lower limbs,but the time and methods of postoperative rehabilitation remain to be researched.To observe the effectiveness and security of Tergumed for early rehabilitation after surgical treatment,we analyzed rehabilitation condition and effect of internal fixation by comparing patients who underwent lumbar disc herniation surgery and started training with Tergumed from the second week after the surgery with those starting training without Tergumed.?Methods? 1.The clinical materials of the 70 patients using Lumbar decompression and internal fixation in Tianjin Teda Hospital were studied retrospectively.2.70 patients were divided into 2 groups at random.Group A consists of 30 patients who underwent lumbar disc herniation surger y and started training with Tergumed from the second week after the surgery.40 patients who started training without Tergumed make up of group B.3.All patients did rehabilitation training for one year.3.1 We observed and compared the results of Oswest ry Disability Index and Visual Analogue Scale(VAS)Pain Score conducted at preoperative time,postoperative 1 week,3 months,6 months and 1 year.3.2 We also observed the condition of looseness and fracture in internal fixation at postoperative 1 week,3 months,6 months and 1 year via X-ray.3.3 Muscular power was seperately tested by Tergumed at preoperative time and postoperative 6 months.?Results? 1.Two groups of patients have no obvious differences in aspect of age,gender and surgical segment.The clinical follow-up is carried out for one year.Two patients in group A quit this research.Besides,in group B,8 patients lose contact with hospital and 4 patients quit the research.2.The looseness and fracture of implants and the instability of adjacent segments don't have no difference between group A and group B.3.There is no obvious difference between group A and group B in Visual Analogue Scale(VAS)Pain Score on the first day and the first week after the surgery.Both groups in VAS Pain Score have statistical differences in the postoperative 3,6 and 12 months.4.In the postoperative 3 and 6 months,all groups in Oswestry Disability Index have evident differences,but in the postoperative 12 months,all groups in Oswestry Disability Index have no statistic differences.5.Compared with preoperative muscular power,there is no statistical differences between muscular power of group A assessed in the postoperative 6th month by Tergumed and preoperative muscular power.but there is statistical differences between muscular power of group B and preoperative muscular power.The muscular power of people in group A recovers faster than muscular power of people in group A.?Conclusion? As a part of early rehabilitation training for patients who have undergone lumbar disc herniation surgery,Tergumed can effectively reduce the posibility of postoperative complications.In addition,Tergumed can relief postoperative pain,reduce the time of postoperative recovery and the rick of looseness and fracture of internal fixation as well. |
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