Lumbal Disk Herniasyonunda Farklı Tedavi Yöntemlerinin Karşılaştırılması

Abstract

The aim of this study is to determine the effectiveness of three different treatment methods which consists spinal decompression, deep friction massage and exercise. Thirty patients (15 Male, 15 female) with lumbar disc herniation between the ages of 28 and 65 (mean age: 46.30±12.94) participated in the study. Group one (n=10) received non-surgical spinal decompression therapy, group two (n=10) received non-surgical spinal decompression, lomber stabilization exercises and deep friction massage, group three (n=10) received deep friction massage and lomber stabilization exercises. All groups completed 15 sessions of therapy. In each session, pain severity was assessed with numeric anolog scale, straight leg raise test applied and the degree of the hip flexion where the patient reported pain were recorded, respectively. Static, dynamic muscle strength-endurance tests were applied before the treatment sessions started, after the treatment sessions ended, six weeks after and three months after the study. Oswestry Diasbility Scale (ODI), Back Performance Scale (BPS), Lanss Neuropathic pain Questionnaire, Fear-Avoidance-Beliefs Questionnaire (FABQ) and McGill Pain Questionnaire were applied before the treatment sessions started, after the treatment sessions ended and three months after the study. Gradient of disc height and thickness of the herniation were assessed segmentally with magnetic rezonans imagination (MRI) before the study and three months after the study. Before the treatment, after the treatment, six weeks after treatment and three months after treatment measurements' intra-group and inter group analyses were distrubuted with Friedman and Kruskal-Wallis tests, respectively and statistical significance value (p) is accepted as 0.05. In terms of disc height and thickness of herniation no statistically difference were found between groups (p>0.05).While disc height and thickness of herniation parameters were statistically difference in first and second group (p<0,05), there was no statistically difference were found in third group before and after treatment (p>0.05). Though there was statistically difference between groups before treatment, there was no statistically difference after treatment in terms of static and dynamic muscle strenght endurance test (p>0.05). Statistically meaningful differences were found in all groups except third group's FABQ work model and Lanss Neuropathic Pain Questionnaire in intra-group analyses of questionnaires (p<0,05). Differences in BPS, Lanss, FABQ work model's inter-group analyses were found meaningful before and after teratment(p<0,05). In this study, effectiveness of the lumbar disc herniation treatments were proven objectively. Intra group analyses showed that decrease in thickness of the herniation and positive resorbtion of the herniated disc were seen in all groups after the treatments. According to MRI results of these treatment methods all methods have similar effects.