earticle

영어

Background: Although the benefits of exercise programs after a lumbar discectomy are well-documented, they are not widely implemented in clinical practice. In particular, there is a lack of research focusing on patients who continue to experience low back pain after surgery. This case report outlines the effects of a structured exercise program on pain, disability, and structural changes in the paraspinal muscles in a patient with persistent low back pain following percutaneous endoscopic lumbar discectomy (PELD). Methods: A 32-year-old male underwent PELD for a herniated disc at the right L4-5 level, but continued to experience low back and radiating pain. Starting four weeks postoperatively, he participated in a rehabilitation program that consisted of spinal stabilization exercises, trunk and hip strengthening, and aerobic exercises performed twice daily. Results: At three months post-surgery, the patient’s pain intensity (NPRS) decreased from 5 to 1, and his disability score (ODI) decreased from 28 to 5. At six months post-surgery, the cross-sectional area (CSA) of the psoas muscle increased, while the CSA of the multifidus and erector spinae muscles decreased. However, asymmetry between the right and left paraspinal muscles was reduced. Additionally, the grade of intramuscular fat infiltration, as measured by the Goutallier classification, showed improvement. Conclusion: This case report shows that a structured exercise program can be effective in reducing pain and disability and improving muscle balance and composition in a patient with persistent low back pain after PELD. These findings support the inclusion of rehabilitation programs in postoperative care for patients with such conditions.