What do patients feel they can do following lumbar microdiscectomy? A qualitative study

Abstract

Purpose. Lumbar microdiscectomy is becoming increasingly popular in the management of prolapsed intervertebral disc. The early stage of rehabilitation has been under-researched, with little documented about optimal activity levels during the initial six weeks. This study aimed to gain insight into patients' experiences of physiotherapy and activity choices during this period.

Method. Eight participants were chosen purposively. All had undergone an uncomplicated lumbar microdiscectomy in the preceding six weeks in an acute neurosurgical unit in the Northeast of England. One-to-one semi-structured interviews were conducted in the participants' homes and transcribed. Data were thematically analysed within a constructionist framework. Mechanisms to ensure analytical rigour were implemented.

Results. Three major themes were derived inductively from the data. The first, ‘wish for precise movement boundaries,’ described participants reduced levels of activity postoperatively as being related to high levels of anxiety about the surgery and fear of re-injury. The second theme suggested that physiotherapy failed to help participants explore their potential for activity. The final theme described post-operative fatigue.

Conclusions. High levels of postoperative anxiety about movement and activity were not addressed postoperatively. This has significant clinical implications and highlights the need for further research.

Keywords:

• Lumbar microdiscectomy
• exercise compliance
• fear avoidance
• qualitative methodology