THE EFFECT OF CONSERVATIVE AND OPERATIVE TREATMENT OF SUBJECTS WITH DISC HERNIATION OF A LUMBAL SPINE. AN OVERVIEW OF THE RESEARCH TO DATE

Degenerativna oboljenja kralježnice spadaju među najčešća oboljenja današnjice. Podaci iz dosadašnje literature ukazuju da čak 80% ljudi se susrelo sa tegobama u donjem odnosno lumbalnom dijelu kralježnice. Cilj ovog rada je istražiti učinkovitost konzervativnog i operativnog liječenja te fizioterapijskih metoda kod osoba sa hernijom diska. Prilikom pregleda i procjene fizioterapeut se koristi subjektivnom i objektivnom procjenom, različitim testovima i mjerenjima. Visual analogue scale (VAS) i Oswestry upitnik su se pokazali kao korisna i kvalitetna metoda u procjeni bolesnikovog stanja. Glavni cilj liječenja hernije diska u lumbalnoj kralježnici je ublažiti bol i popratne simptome. Da bi se postigao zadani cilj, plan liječenja za svakog pacijenta treba biti individualiziran. Najčešći način liječenja simptoma uzrokovanih hernijom je konzervativni, a u slučaju pogoršanja simptoma može se pribjeći agresivnijim metodama terapije. Fizioterapija ima značajnu ulogu u konzervativnom liječenju, ali i u pripremama za rehabilitaciju nakon operativnog liječenja. Od mnogobrojnih fizikalnih agensa, ostale fizioterapijske metode koje su učinkovite kod hernije diska su vojta terapija, dinamička neuromuskularna stabilizacija (DNS), McKenzie metoda i proprioceptiva neuromuskularna facilitacija (PNF).Degenerative diseases of the spine are among the most common diseases today. Data from the literature so far indicate that as many as 80% of people have encountered problems in the lower or lumbar spine. The aim of this study was to investigate the effectiveness of conservative and operative treatment and physiotherapy methods in persons with disc herniation. During the examination and assessment, the physiotherapist uses subjective and objective assessment, various tests and measurements. The Visual Analogue Scale (VAS) and the Oswestry Questionnaire have proven to be a useful and quality method in assessing a patient’s condition. The main goal of treating a herniated disc in the lumbar spine is to relieve pain and accompanying symptoms. In order to achieve the set goal, the treatment plan for each patient needs to be individualized. The most common way to treat the symptoms caused by a hernia is conservative, and in case of worsening of the symptoms, more aggressive methods of therapy can be resorted to. Physiotherapy plays a significant role in conservative treatment, but also in preparations for rehabilitation after surgical treatment. Of the many physical agents, other physiotherapy methods that are effective in disc herniation include Vojta therapy, dynamic neuromuscular stabilization (DNS), the McKenzie method, and proprioceptive neuromuscular facilitation (PNF)