The correlation between residual symptoms of lower limbs and hip joint range of motion (ROM) after lumbar discectomy

抄録

【Background/Purpose】

 Lumbar discectomies are conducted when conservative treatments do not relieve low-back pain (LBP) and radiculopathy due to lumbar disc herniation (LDH). However, some of these patients still remain symptomatic after discectomy, because nerve root compression may occur not only at LDH, but also in peripheral areas such as at piriformis. The purpose of this study was to examine the correlation between residual symptoms and hip joint ROM after lumbar discectomies.

 

【Methods】

 Records of 28 patients (23 male, 5 females), aged 20 to 59 years who underwent lumbar discectomies from July 2015 to April 2017 were included in our study. The main outcome measurements were the severity of LBP, lower limb pain, and numbness using visual analogue scale (VAS). The secondary outcome of hip flexion, SLR, internal rotation (IR) and external rotation at 90 degrees of hip flexion were measured on both symptomatic and asymptomatic side. These outcome measurements were taken before and one month after surgery. The definition of improvement in each category was the subtraction of pre to post VAS score, and the post to pre ROM. Correlations between the improvements of each symptom and each category of hip ROM were analysed using the Pearson’s coefficient of correlation or Spearman's rank-correlation coefficient, using analysis software SPSS ver.12.0.

 

【Results】

 Only the improvements of lower limb numbness and the increase of symptomatic side of hip IR at 90 degree flexion showed moderate positive correlation(r=0.50). Other outcome measurements did not show any correlations between each category.

 

【Discussion/Conclusion】

 Our results suggest that the residual symptoms after lumbar discectomies are caused by the compression of the sciatic nerve root due to tightness of hip rotator muscles. Increasing ROM of hip IR at 90 degrees may lead to improvements in residual symptoms.

 

【Ethical consideration】

This study has considered the declaration of Helsinki.