Whether Out-of-Bed Activity Restriction in the Early Postoperative Period of PELD Is Beneficial to Therapeutic Efficacy or Reduce Recurrence

Abstract

ObjectiveTo detect the influences of postoperative out-of-bed activity restriction on recurrence rate, low back and leg pain, functional rehabilitation after percutaneous endoscopic lumbar discectomy (PELD).MethodsIn this research, 213 patients with lumbar intervertebral disc herniation (LDH) who underwent PELD were divided into the out-of-bed activity restriction group and out-of-bed activity non-restriction group. The visual analog scale (VAS) and Oswestry disability index (ODI) scores were used to evaluate postoperative clinical efficacy at 1 and 3 months after the operation, and to count the recurrence rates. All of these operations were performed between August 2017 and July 2020, and they were followed in the outpatient department for 12 months at least.ResultsBoth of the groups showed significantly lower VAS and higher ODI scores at 1 month and 3 months post-operation, respectively, when compared with pre-operation. At 1 month after the operation, the restriction group performed lower VAS scores of low back pain compared with the non-restriction group, but this advantage disappeared at 3months post-operation. However, there was no statistical difference in the VAS scores of leg pain and ODI scores between the two groups, neither at 1 nor 3 months after the surgery. The recurrence rate is significantly lower in the restriction group than in the non-restriction group at a 12-month follow-up after the surgery.ConclusionOut-of-bed activity restriction in the early postoperative period of PELD could reduce LDH recurrence effectively, and it may relieve the low back pain to some extent. It has no benefit in the recovery of leg pain and functional rehabilitation.

Does Immediate Postoperative Early Ambulation Affect Clinical Results of Full‐Endoscopic Lumbar Discectomy? A Historical Control Study of Daytime Operation with a 8‐Hour Hospital Stay versus Inpatient Operation

“…Within the 8‐h hospital stay, all the day surgery patients were suggested to ambulate 2 h after surgery. A recent study reported out‐of‐bed activity restriction in the early postoperative period of ELD could reduce LDH recurrence 4 . However, there were no differences between the two groups in clinical effects and revision rates.…”

“…According to previous studies, the revision rates for FELD were 1.96%–6.05% 9,17,20 . A recent study showed early ambulation may be one of the factors affecting recurrence after ELD 5 and another study reported that out‐of‐bed activity restriction in the early postoperative period of ELD could reduce LDH recurrence effectively 4 . In our study, the first ambulation time in FELD‐D group was only 2 h and discharged around 2–3 h post‐operation.…”

“…Some experts believed that early ambulation may be one of the factors affecting recurrence after ELD. 4,5 Full-endoscopic lumbar discectomy (FELD) is a popular operation for the treatment of lumbar disc herniation (LDH). Because FELD has many advantages, such as less trauma, fewer complications, and satisfactory results while minimizing postoperative instability.…”

“…To date, there is lack of a uniform worldwide viewpoint on whether first ambulation time, discharge time, or time of return to work after ELD affects the clinical efficacy and recurrence rate. Some experts believed that early ambulation may be one of the factors affecting recurrence after ELD 4,5 …”

Development and Validation of a Nomogram Predicting Postoperative Recurrent Lumbar Disc Herniation Based on Activity Factors

“…The researchers attributed the increased risk of recurrence to the elevation of IDP caused by early mobilization. Furthermore, Liang et al 25 conducted a 12-month follow-up study on 213 patients who underwent PELD to observe the recurrence rates between the restricted and unrestricted mobilization groups. Restricted mobilization was defined as less than 1 hour of daily mobilization within 2 weeks postoperatively, with each session lasting less than 30 minutes.…”