Rehabilitation following lumbosacral percutaneous nucleoplasty: a case report

• Published in: The journal of orthopaedic and sports physical therapy Vol. 40; no. 4; pp. 214 - 224
• Main Authors: Puentedura, Emilio J, Brooksby, Candi L, Wallmann, Harvey W, Landers, Merrill R
• Format: Journal Article
• Language: English
• Published: United States 01-04-2010
• Subjects: Decompression, Surgical - methods; Decompression, Surgical - rehabilitation; Diskectomy, Percutaneous - methods; Diskectomy, Percutaneous - rehabilitation; Humans; Intervertebral Disc Degeneration - complications; Intervertebral Disc Degeneration - surgery; Lumbar Vertebrae - surgery; Male; Middle Aged; Muscle Weakness - etiology; Muscle Weakness - therapy; Physical Therapy Modalities; Postoperative Care; Range of Motion, Articular; Recovery of Function; Sacrum - surgery; Treatment Outcome
• ISSN: 0190-6011; 1938-1344
• DOI: 10.2519/jospt.2010.3115

Case report.
Lumbar spine nucleoplasty is a new surgical option for patients with disc pathology. There are no reports in the literature describing the role of physical therapy in postoperative lumbar nucleoplasty management. The purpose of this case is to describe the postoperative physical therapy management of a patient who underwent this procedure.
A 50-year-old male, 7 weeks following a L5/S1 lumbar nucleus replacement, completed 6 weeks of rehabilitation. The focus of the treatment was controlled reloading of the spine through a spinal stabilization progression in weight-bearing and non-weight-bearing activities. In addition, education, spinal manual therapy techniques, and a home exercise program were also incorporated.
The patient's Oswestry Disability Index decreased from 56% to 4% over 6 weeks of treatment. When contacted at 6, 12, 18, and 24 months posttherapy, his Oswestry Disability Index was 2%, 2%, 0%, and 0%, respectively, and he had returned to all previous activities without recurrence of symptoms.
This case report outlines the clinical decision-making process during the postoperative management of an individual who had undergone a single-level lumbar nucleoplasty. A postoperative regimen of education, segmental spinal stabilization, and a home exercise program might have contributed to the observed improvement in pain and disability levels in this patient. The role of these postoperative interventions warrants further research.
Therapy, level 4.