Our Summary

This research paper looked at whether the quality of certain back muscles, specifically the paralumbar and psoas muscles, had any impact on patient-reported results or surgical outcomes after a specific type of back surgery (lumbar microdiscectomy).

The study involved adults who had undergone this surgery between 2014 and 2021. The researchers examined various measures of patients’ health before surgery, and at several points up to a year after surgery. They also looked at whether patients had to be readmitted to the hospital or have further surgery.

They found that higher quality in the psoas muscle (a major muscle of the lower back) was linked to better physical recovery after surgery. However, the quality of these muscles did not affect whether patients had to return to the hospital or have more surgery. There was no consistent impact observed from the quality of the paralumbar muscles (a group of muscles that run along the sides of the spine) on patient-reported outcomes.

The researchers concluded that more research is needed to fully understand how the quality of these muscles might affect recovery after this type of back surgery.

FAQs

  1. Does the quality of certain back muscles impact the outcomes after a lumbar microdiscectomy?
  2. What role does the quality of the psoas muscle play in recovery after lumbar microdiscectomy?
  3. Does the quality of the paralumbar muscles affect patient-reported outcomes after lumbar microdiscectomy?

Doctor’s Tip

A doctor may advise a patient undergoing microdiscectomy to focus on strengthening their psoas muscle before and after surgery to potentially improve physical recovery outcomes. They may also recommend working with a physical therapist to develop an individualized exercise plan to target these specific muscles. It’s important to follow post-operative instructions and attend follow-up appointments to monitor progress and address any concerns.

Suitable For

Patients who are typically recommended for microdiscectomy are those who have a herniated disc in the lumbar spine that is causing symptoms such as leg pain, numbness, or weakness. These symptoms may be due to nerve compression caused by the herniated disc. Patients who have not found relief from conservative treatments such as physical therapy, medication, or injections may be candidates for microdiscectomy.

Additionally, patients who have tried conservative treatments for a period of time (typically 6-12 weeks) and continue to experience severe symptoms that interfere with daily activities or quality of life may also be recommended for microdiscectomy. Patients who have signs of nerve damage, such as muscle weakness or loss of bladder or bowel control, may also be candidates for surgery.

Overall, the decision to recommend microdiscectomy is based on a thorough evaluation of the patient’s symptoms, medical history, physical examination findings, and imaging studies such as MRI or CT scans. The goal of microdiscectomy is to relieve nerve compression, reduce pain, and improve function and quality of life for the patient.

Timeline

Before microdiscectomy:

  1. Patient experiences back pain, leg pain, numbness, or weakness due to a herniated disc pressing on a nerve.
  2. Patient undergoes imaging tests such as MRI or CT scan to confirm the diagnosis.
  3. Patient may try conservative treatments such as physical therapy, medication, or epidural steroid injections to manage symptoms.

After microdiscectomy:

  1. Patient undergoes surgery to remove the herniated portion of the disc that is causing symptoms.
  2. Immediately after surgery, patient may experience some pain and discomfort at the surgical site.
  3. In the weeks following surgery, patient gradually resumes normal activities and physical therapy to strengthen the back muscles.
  4. Over time, patient experiences improvement in symptoms such as reduced pain, numbness, and weakness.
  5. Patient continues to follow up with their surgeon and physical therapist to monitor progress and prevent future issues.

Overall, the timeline for a patient before and after microdiscectomy involves initial symptoms, diagnosis, surgery, recovery, and rehabilitation to achieve optimal outcomes.

What to Ask Your Doctor

Some questions a patient should ask their doctor about microdiscectomy based on this research include:

  1. How does the quality of my paralumbar and psoas muscles impact my recovery after microdiscectomy surgery?
  2. Are there specific exercises or physical therapy techniques I can do to improve the quality of these muscles before surgery?
  3. Will the quality of my muscles be assessed before surgery, and if so, how?
  4. What can I expect in terms of physical recovery based on the quality of my muscles?
  5. Are there any specific precautions or recommendations for patients with lower quality paralumbar or psoas muscles undergoing microdiscectomy surgery?
  6. How long should I expect to be in the hospital after surgery, and what are the chances of needing readmission or further surgery based on the quality of my muscles?
  7. Will my post-operative rehabilitation plan be adjusted based on the quality of my muscles?
  8. Are there any additional imaging tests or evaluations that should be done to assess the quality of my muscles before surgery?

Reference

Authors: Heard JC, Kohli M, Ezeonu T, Lee Y, Lambrechts MJ, Narayanan R, Kirkpatrick Q, Kern N, Canseco JA, Kurd MF, Kaye ID, Hilibrand AS, Vaccaro AR, Schroeder GD, Kepler CK. Journal: World Neurosurg. 2024 Mar;183:e687-e698. doi: 10.1016/j.wneu.2024.01.003. Epub 2024 Jan 4. PMID: 38184224