Turkish Journal of Physical Medicine and Rehabilitation 2007 , Vol 53 , Num 3
Evaluation of the Efficacy of Conservative Therapies with Clinical Parameters and Magnetic Resonance Imaging in Lumbar Disc Herniations
F. Devrim Meydan Ocak 1 ,Murat Karaaslan 2 ,İlyas Tutar 3 ,Nilnur Konuralp 3 ,Aliye Yıldırım Güzelant 4 ,Mehmet Hayri Özgüzel 5
1 SSK Okmeydanı Eğitim ve Araştırma Hastanesi Fizik Tedavi ve Rehabilitasyon Kliniği, İstanbul
2 Echomar Görüntüleme Merkezi, Istanbul
3 SSK Okmeydanı Eğitim ve Araştırma Hastanesi Fizik Tedavi ve Rehabilitasyon Kliniği, İstanbul
4 Okmeydanı Eğitim ve Araştırma Hastanesi Fizik Tedavi ve Rehabilitasyon Kliniği, İstanbul
5 Sağlık Bakanlığı Okmeydanı Eğitim ve Araştırma Hastanesi, Fizik Tedavi ve Rehabilitasyon Kliniği, İstanbul

Objective: To examine the effects of conservative therapies on the outcomes of physical examination, scores of pain and functional activity and lumbar magnetic resonance imaging (MRI) in lumbar disc hernias.
 

Materials and Methods: Twenty-five patients with protrusions or extrusions detected in lumbar MRI were examined. All the patients’ 
physical examination findings, scores of visual analogue scale (VAS) at rest and activity and modified Oswestry functional disability scale were recorded. Conservative therapy methods, such as bed rest, anti-inflammatory and myorelaxant medications, physical treatment agents, exercise and suggestions for daily life were applied. The outcomes of therapies were again evaluated after about 1.5 (1.56±0.39) and 4.5 (4.68±1.42) months by physical examination, lumbar MRI, scores of VAS at rest, VAS at activity and modified Oswetry functional disability scale. Clinical findings and the outcomes of lumbar MRI of the first and second follow-up examinations were compared before treatment.
 

Results: Significant improvements were detected in physical examination findings and VAS and Oswetry scores, but not in lumbar MRI findings in the first follow-up which was applied after 1.5 months. Significant improvents were detected in both clinical findings and radiological outcomes in the second follow-up which was applied after 4.5 months.
 

Conclusion: We think that conservative therapies, including physical treatment modalities, bed rest, medications and exercise have early effecs on clinical findings in lumbar disc hernias and they may cause late morphological differentiations, by the help of natural process of herniation, as well. 

Keywords : Lumbar disc hernias, conservative treatment, magneticresonance imaging