Postural instability after lumbar spinal surgery: are there any predictive factors? A case control study

Area of Science:

• Neurosurgery
• Physical Therapy
• Rehabilitation Medicine

Background:

• Degenerative spinal pathologies, primarily herniated intervertebral discs, often necessitate surgical intervention.
• While surgery yields positive outcomes in ~90% of cases, 4-20% of patients experience residual pain and postural instability post-discectomy.
• Post-surgical postural instability presents a significant challenge in patient recovery and quality of life.

Purpose of the Study:

• To evaluate the efficacy of postural gymnastics in treating post-surgical postural instability in patients with degenerative lumbar disease.
• To assess the impact of a structured exercise program on patient recovery and functional outcomes.
• To provide a non-invasive therapeutic option for managing residual symptoms after spinal surgery.

Main Methods:

• A retrospective analysis of patients with degenerative lumbar disease who developed post-surgical postural instability.
• Implementation of structured postural gymnastics cycles including breathing, muscular distension, reinforcement, and correction exercises.
• Utilized a custom-designed evaluation form assessing muscle and respiratory function to quantify postural instability severity (mild, medium, severe).

Main Results:

• Satisfactory outcomes were achieved, with patients returning to normal posture.
• Significant improvement in postural instability was evidenced by evaluation scores, transitioning from severe to normal intensity.
• Clinical assessment confirmed improvements in both static and dynamic posture.

Conclusions:

• Postural instability following spinal surgery is multifactorial, involving vertebral, pelvic, paraspinal muscular, and neural structures.
• Surgical interventions and acquired conditions like obesity can alter these structures, contributing to instability.
• Postural gymnastics offers a viable and effective solution for managing post-surgical postural instability.