Effectiveness of Physiotherapy and Rehabilitation in a Patient with Drop Foot After Repeated Failed Spinal Surgeries-Case Report

Yıl 2024, Cilt: 2 Sayı: 1, 14 - 20, 24.06.2024

Gizem Soylu , Hasan Erkan Kılınç

Öz

Purpose: The aim was to report the effects of physiotherapy and rehabilitation on pain, drop foot severity, lower extremity range of motion, muscle strength, disability level and emotional status in a 64-year-old male patient with repeated failed lumbar spinal surgery.

Case Presentation: Pain severity was assessed using the Numeric Pain Scale; range of motion of the trunk, lower extremity and foot was measured using the Universal Goniometer; hip, knee, ankle and big toe muscle strength was assessed using the Manual Muscle Strength Test, The Oswestry Disability Questionnaire and the Roland Morris Disability Questionnaire were used to assess disability status due to low back pain, the Short Form-36 Quality of Life Scale (SF-36) was used to assess quality of life and the Beck Depression Scale was used to assess emotional status.

Results: Improvements were noted in the severity of the drop foot, the level of pain during activity, particularly in the active range of motion of lumbar flexion, extension and hip flexion, and in the muscle strength of the lower extremities, with right dorsal flexion being the most prominent. In addition, significant positive changes were reported in the Ostwesrty Disability Index, Roland Morris Disability Questionnaire and SF-36 physical function sub-parameter scores. Finally, the daily use of anesthetics was discontinued.

Discussion: In patients who have undergone failed lumbar spinal surgery, treatment options with potential risks such as side effects, addiction and complications are widely used. Physiotherapy and rehabilitation can be considered as the first option in these patients.

Anahtar Kelimeler

Disc herniaton, surgery, physiotherapy, pain

Kaynakça

• 1. Abas Ah, Daud A, Mohd Hairon S, Shafei Mn. Prevalence And Risk Factors Of Low Back Pain In Malaysia: A Scoping Review. Malays J Med Sci. 2023;30(3):32-41.
• 2. Calais-Ferreira L, Pozzobon D, Pinheiro Mb, Blyth Fm, Ordonana Jr, Duncan Ge, Et Al. Sex Differences In Lifetime Prevalence Of Low Back Pain: A Multinational Study Of Opposite-Sex Twin Pairs. Eur J Pain. 2023;27(10):1150-60.
• 3. Ferreira Ml, De Luca K, Haile Lm, Steinmetz Jd, Culbreth Gt, Cross M, Et Al. Global, Regional, And National Burden Of Low Back Pain, 1990–2020, Its Attributable Risk Factors, And Projections To 2050: A Systematic Analysis Of The Global Burden Of Disease Study 2021. The Lancet Rheumatology. 2023;5(6):E316-E29.
• 4. Kobayashi K, Sato K, Kato F, Kanemura T, Yoshihara H, Sakai Y, Et Al. Trends In The Numbers Of Spine Surgeries And Spine Surgeons Over The Past 15 Years. Nagoya J Med Sci. 2022;84(1):155-62.
• 5. Thomson S. Failed Back Surgery Syndrome - Definition, Epidemiology And Demographics. Br J Pain. 2013;7(1):56-9.
• 6. Classification Of Chronic Pain. Descriptions Of Chronic Pain Syndromes And Definitions Of Pain Terms. Prepared By The International Association For The Study Of Pain, Subcommittee On Taxonomy. Pain Suppl. 1986;3:S1-226.
• 7. Baber Z, Erdek Ma. Failed Back Surgery Syndrome: Current Perspectives. J Pain Res. 2016;9:979-87.
• 8. Fortner Mo, Woodham Tj, Haas Jw, Oakley Pa, Harrison De. Failed Back Surgery Syndrome Successfully Ameliorated With Chiropractic Biophysics((R)) Structural Rehabilitation Improving Pain, Disability As Well As Sagittal And Coronal Balance: A Chiropractic Biophysics((R)) Case Report With A 6 Year Follow-Up. J Phys Ther Sci. 2024;36(1):44-50.
• 9. Devillé Wl, Van Der Windt Da, Dzaferagic A, Bezemer P, Bouter Lm. The Test Of Lasegue: Systematic Review Of The Accuracy In Diagnosing Herniated Discs. Spine. 2000;25(9):1140-7.
• 10. Jamshidi N, Rostami M, Najarian S, Menhaj Mb, Saadatnia M, Salami F. Assessment Of Ground Reaction Forces Of Steppage Gait In Comparison With Normal Gait. Journal Of Musculoskeletal Research. 2009;12(01):45-52.
• 11. Yakut E, Düger T, Öksüz Ç, Yörükan S, Üreten K, Turan D, Et Al. Validation Of The Turkish Version Of The Oswestry Disability Index For Patients With Low Back Pain. Spine. 2004;29(5):581-5.
• 12. Roland M, Fairbank J. The Roland–Morris Disability Questionnaire And The Oswestry Disability Questionnaire. Spine. 2000;25(24):3115-24.
• 13. Küçükdeveci Aa, Tennant A, Elhan Ah, Niyazoglu H. Validation Of The Turkish Version Of The Roland-Morris Disability Questionnaire For Use In Low Back Pain. Spine. 2001;26(24):2738-43.
• 14. Instrument Ware Jr J, Sherbourne C. The Mos 36-Item Short-Form Health Survey (Sf-36): I. Conceptual Framework And Item Selection. Medical Care. 1992;30(6):473-83.
• 15. Kocyigit H. Reliability And Validity Of The Turkish Version Of Short Form-36 (Sf-36): A Study In A Group Of Patients Will Rheumatic Diseases. Turk J Drugs Ther. 1999;12:102-6.
• 16. Beck At, Ward Ch, Mendelson M, Mock J, Erbaugh J. An Inventory For Measuring Depression. Archives Of General Psychiatry. 1961;4(6):561-71.
• 17. Akuthota V, Ferreiro A, Moore T, Fredericson M. Core Stability Exercise Principles. Current Sports Medicine Reports. 2008;7(1):39-44.
• 18. Park Hs, Park Sw, Oh Jk. Effect Of Adding Abdominal Bracing To Spinal Stabilization Exercise On Lumbar Lordosis Angle, Extensor Strength, Pain, And Function In Patients With Non-Specific Chronic Low Back Pain: A Prospective Randomized Pilot Study. Medicine (Baltimore). 2023;102(41):E35476.
• 19. Watts C. Syndrome Of Intradiscal Lumbar Herniation. Clinical Presentation And Management. Surg Neurol. 1988;30(4):263-7.
• 20. Yavuzer G, Geler-Kulcu D, Sonel-Tur B, Kutlay S, Ergin S, Stam Hj. Neuromuscular Electric Stimulation Effect On Lower-Extremity Motor Recovery And Gait Kinematics Of Patients With Stroke: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2006;87(4):536-40.
• 21. Chu Ec, Trager Rj. Effectiveness Of Multimodal Chiropractic Care Featuring Spinal Manipulation For Persistent Spinal Pain Syndrome Following Lumbar Spine Surgery: Retrospective Chart Review Of 31 Adults In Hong Kong. Med Sci Monit. 2022;28:E937640.