Recovery after Back Surgery Isn't Always Automatic

Movement. Posture. Control. It all seems so easy. In fact, the healthy body is on "automatic" most of the time. The body senses movement and responds to it. The muscles protect from injury by contracting at the right time. Sensors in the trunk and legs signal the body to hold still or stand upright.

All of these actions are part of a system called the central movement control system. Low back pain (LBP) can throw a monkey wrench in the system. Suddenly, muscle control and posture isn't so automatic.

Scientists are studying the link between chronic LBP and the central movement control system. In this study, researchers looked at impaired postural control in patients with sciatica before and after surgery. Normal adults without back pain were compared to back pain patients with sciatica from a herniated disc. The back pain patients all had an operation to remove the disc (discectomy).

A special machine was used to measure motion in the low back. A separate device measured postural control. Reaction time of muscles in response to unexpected movement was also recorded. In this small study (20 patients), low back and leg pain decreased after surgery. Disability and depression also improved.

The authors think the impaired sense of movement present in sciatica patients can be restored. Regaining control of posture isn't so easy. They found that full recovery of the movement control system isn't automatic after discectomy. A longer follow-up study is needed to find out how long it takes before healing occurs.

Ville Leinonen, MD, et al. Lumbar Paraspinal Muscle Function, Perception of Lumbar Position, and Postural Control in Disc Herniation-Related Back Pain. In Spine. April 15, 2003. Vol. 28. No. 8. Pp. 842-848.

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