Postoperative early initiation of sequential exercise program in preventing persistent spinal pain syndrome type-2 after modified transforaminal lumbar interbody fusion: a prospective randomized controlled trial.

研究概要

Three hundred ninety-five patients with lumbar degenerative diseases were randomized to receive either early sequential motor control and core stabilization training (n=214) or conventional exercise (n=181) following modified transforaminal lumbar interbody fusion. The primary outcome of interest was the incidence of persistent spinal pain syndrome type-2 (PSPS-T2) at one year postoperatively. Secondary outcomes included low back pain (LBP) intensity, Oswestry Disability Index (ODI), pressure pain threshold (PPT), temporal summation (TS), fatty infiltration of paraspinal muscles, transversus abdominis (TrA) activation capacity, and Fear-Avoidance Beliefs Questionnaire (FABQ) scores at 3 months and 1 year postoperatively. Overall, the results revealed that significantly fewer patients in the sequential exercise group developed PSPS-T2 compared to the conventional exercise group. Additionally, the sequential group exhibited lower LBP, greater PPT, lower TS, improved TrA activation, and reduced fatty infiltration of erector spinae at both follow-up points. These findings suggest that early initiation of postoperative sequential exercise is more effective in preventing PSPS-T2 and improving pain modulation compared to conventional exercise.