Rehabilitation after herniated lumbar disc surgery

Bol u leđima jedan je od vodećih zdravstvenih problema današnjice koji je uzrokovan primarno promjenom načina života te zahvaća sve mlađu populaciju, posebno u trećem desetljeću života. Zbog dugotrajnosti problema, sklonosti povratku boli te učestalim izostancima s radnog mjesta predstavlja veliki socijalni i financijski problem. Postoje razni entiteti koji mogu prouzročiti nastanak boli, a jedan od njih je hernija diska. Najčešće mjesto na kojem nastaje hernija diska je lumbalna kralježnica. Simptomi poput boli, parestezija udova, nekontroliranja sfinktera i smanjene pokretljivosti kralježnice u značajnoj mjeri umanjuju kvalitetu života te obavljanje normalnih aktivnosti. Cilj ovog preglednog rada je prikazati problem boli u leđima, a posebno hernije diska u lumbalnom dijelu kralježnice, način prezentacije bolesnika, dijagnostike, modalitete nefarmakološkog, farmakološkog i operacijskog liječenja. Fokus rada je usmjeren na rehabilitaciju nakon operacije hernije diska, a tijek samog programa bit će podijeljen po stadijima u trajanju od nekoliko tjedana. Svakom bolesniku treba pristupiti individualno, većina bolesnika se razlikuje po uobičajenim aktivnostima te zahtjevima za normalno funkcioniranje. Postoje brojni programi rehabilitacije te njihove modifikacije ovisno o specifičnim potrebama bolesnika, a ovdje će biti prikazani osnovni postulati kojih se treba pridržavati u rehabilitaciji. Važnost edukacije bolesnika o bolesti, načinu života, postoperativnom pridržavanju točnih uputa i postupnost u cijelom procesu rehabilitacije naglašena je kroz cijeli rehabilitacijski program.Back pain is one of the leading health problem nowadays, primarily caused by lifestyle changes, and affects the younger population, especially in the third decade of life. Due to the long duration of the problem, the tendency of recurrent pain pattern and frequent absence from the workplace is a major social and financial problem. There are various entities that can cause pain, and one of them is a herniated disc. The most common place where a herniated disk forms is the lumbar spine. Symptoms such as pain, paresthesia of the limbs, uncontrolled sphincter and reduced spinal mobility cause a significant reduction in the quality of life and performance of everyday activities. The aim of this review is to show the problem of low back pain, especially due to a herniated disc in the lumbar spine, the way patients are presented, and diagnostics, as well as modalities of nonpharmacological, pharmacological and operative treatment. The focus of the review is on rehabilitation after the herniated disc surgery, and the phases of the program itself will be divided over several weeks. Each patient should be accessed individually, since most patients differ according to their usual activities and requirements for normal functioning. There are numerous rehabilitation and modification programs, depending on the patients' needs, and here the basis that must be adhered to will be presented. The importance of educating the patient about his illness, lifestyle, postoperative adherence to accurate instructions, and gradualness throughout the rehabilitation process is emphasized throughout the entire rehabilitation program