Does Adequate Lumbar Segmental Motion Reflect Recovery Process in Acute Lumbar Disc Herniation?

Area of Science:

• Orthopedics
• Radiology
• Pain Management

Background:

• Acute low back pain is often caused by lumbar disc herniation (LDH).
• Assessing recovery in LDH patients typically involves pain intensity, but the role of spinal mobility is less understood.

Purpose of the Study:

• To determine if lumbar segmental motion correlates with pain reduction during recovery in patients with acute single-level LDH.

Main Methods:

• Retrospective review of 46 patients with single-level LDH (L4-L5 or L5-S1) diagnosed between 2011-2017.
• Analysis included lumbar spine MRI and functional radiography data.
• Pearson correlation assessed the relationship between pain intensity (VAS) and segmental range of motion (sROM) at initial evaluation and follow-ups.

Main Results:

• An inverse correlation was found between changes in visual analogue scale (VAS) and sROM at L4-L5 (r=-0.69, p<0.05).
• Percentage of sROM negatively correlated with pain intensity at L4-L5 (r=-0.74, p<0.05).
• Initial pain intensity inversely correlated with sROM at both L4-L5 (r=-0.83, p<0.01) and L5-S1 (r=-0.82, p<0.05).

Conclusions:

• Improved sagittal mobility in the affected lumbar segment reflects reduced low back pain during recovery from LDH.
• This suggests the affected spinal segment is overcoming immobilization.
• An inverse relationship exists between initial pain intensity and the limitation of sagittal range of motion in LDH.