Comparison of Physical Therapy Follow-Up of Patients with Operated and Non-Operated Lumbar Spinal Stenosis According to the Nottingham Health Profile-Pain Scale

摘要

Background: Lumbar spinal stenosis (LSS) continues to be a major problem in societies, causing job loss and lowering quality of life. There are two types of treatment methods, physical therapy and surgery. If patients with LSS avoid treatment, they are likely to experience neurological deterioration in later years. Objective: The study aimed to evaluate the effect of physical therapy applied after decompression surgery or the effect of only applied physical therapy in patients with lumbar spinal stenosis. Materials and Methods: The results of the physical therapy follow-up of patients who had surgery and did not have surgery due to lumbar spinal stenosis between July 2014 and December 2019 were compared with each other. All patients received physical therapy for 6 months. Included were 42 patients who underwent decompression surgery due to LSS ; 56 patients were not operated. Clinical outcomes were measured using the Nottingham Health Profile-Pain (NHP-Pain) scale at the initial, first, third and sixth months. The results were compared statistically. Results: The age of the operated patients was 54.69 ± 8.42 (39 - 71), while the non-operated patients were 59.16 ± 14.04 (34 - 83). There was no significant difference in the statistical comparison (p = 0.053). While the body mass index (BMI) of the operated patients was 29.43 ± 4.99 (21 - 40), the BMI of the non-operated patients was 28.84 ± 4.62 (22 - 42). There was no significant difference in the statistical comparison (p = 0.552). The scores of a 6-month physical therapy follow-up of patients were evaluated according to the NHP-pain scale. The values of patients who underwent surgery, initial - 1st month (p < 0.001), 1st month - 3rd month (p = 0.028), 3rd month - 6th month (p = 0.389) follow-up of the intervals were compared statistically. The values of non-operated patients, initial - 1st month (p = 0.008), 1st month -3rd month (p = 0.013), 3rd month - 6th month (p = 0.025) were compared statistically. Patients with and without surgery had significantly different initial pain scores (p < 0.001). Conclusions: The NHP-Pain scores of the patients undergoing physical therapy with the operation were shown to provide more significant improvement than the group receiving only the physical therapy. Patients with LSS should be treated with an operation to obtain the maximum benefit of physical therapy.