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Risicofactor screening en behandeling op maat na een operatie voor een lumbale hernia nuclei pulposi

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Stimulus

Samenvatting

Jaarlijks worden circa 12.000 patiënten geopereerd aan een lumbale hernia nuclei pulposi (HNP) en circa 50% van de patiënten heeft nog pijn, beperkingen bij dagelijkse activiteiten en/of verlies van werkcapaciteit een halfjaar na de operatie. Onderzoek naar de effectiviteit van oefentherapie na een operatie voor een HNP heeft aangetoond dat patiënten wel sneller herstellen na intensieve oefentherapie, maar niet dat patiënten beter herstellen op langere termijn. In alle onderzochte studies is echter een standaardinterventie toegepast en was de behandeling niet gebaseerd op vooraf geïdentificeerde risicofactoren voor een ongunstig herstel. Voor patiënten met aspecifieke rugklachten en andere aandoeningen van het houdings- en bewegingsapparaat is echter in verschillende studies aangetoond dat een op risicofactoren gericht behandelprogramma effectiever is dan een standaardbehandeling. Deze bijdrage beschrijft welke risicofactoren een ongunstig herstel na een HNP-operatie voorspellen en welke behandelstrategieën kunnen worden gekozen om deze factoren te beïnvloeden.

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Acknowledgments

Dit artikel is gebaseerd op het proefschrift ‘Predicting disability, pain and work capacity after surgery for a Lumbosacral Radicular Syndrome’ dat tot stand is gekomen in samenwerking met prof. dr. R.A.B. Oostendorp, dr. A.W.M. Evers (medisch psycholoog), dr. M. Munneke, (epidemioloog/fysiotherapeut), drs. T. Beems (neurochirurg), prof. dr. F. Kraaimaat (medisch psycholoog) en prof. dr. A. Grotenhuis (neurochirurg).

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  1. Afdeling Revalidatie, UMC St Radboud, Nijmegen, The Netherlands

    J.J. den Boer

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  1. J.J. den Boer
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den Boer, J. Risicofactor screening en behandeling op maat na een operatie voor een lumbale hernia nuclei pulposi. STIMULUS 28, 27–36 (2009). https://doi.org/10.1007/s12491-009-0004-9

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