2026 Volume 53 Issue 4 Pages 247-255
Objective: To clarify the effects of postoperative neural mobilization (NM) on the physical function of patients who have undergone lumbar spine surgery.
Methods: We enrolled 36 patients with lumbar spinal stenosis or degenerative spondylolisthesis who underwent decompression or fusion surgery (NM group, n=20; control group, n=16). Both groups underwent conventional rehabilitation starting on postoperative day one. Additionally, the NM group undertook therapist-assisted and self-performed passive neck flexion exercise (PNFE), which was initiated at a frequency of 60 repetitions and increased to 150 repetitions daily from the second day until discharge. The primary outcome was the Oswestry Disability Index (ODI) score at 1 month postoperatively, which was analyzed using the analysis of covariance. Secondary outcomes included the pain and numbness intensity, Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) score, and Straight Leg Raise (SLR) test.
Results: Compared with the control group, the NM group demonstrated significantly greater ODI improvement (regression coefficient: −12, 95% confidence interval [−20 to −4], p=0.003). Secondary outcomes, including Visual Analog Scale scores for pain and numbness, JOABPEQ scores, and SLR angles, improved in both groups over time albeit without significant between-group differences.
Conclusion: Postoperative PNFE-based NM intervention is a feasible rehabilitative option that effectively improves physical function in patients after lumbar spine surgery.
