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May 1999 Volume 15, Number 24
Department of Orthopaedic Surgery, Toyama Medical and Pharmaceutical University, Japan

Study Outcomes & Clinical Relevance: Back muscle injury was directly related to the muscle retraction time during surgery. The damage to the multifidus muscle was more severe and the recovery of extensor muscle strength was delayed in the long-retraction-time group. In addition, the incidence of postoperative low back pain was significantly higher in the long-retraction-time group.

Although lumbar surgery is often thought to fix whatever is broken, it can introduce new dysfunction such as injury to the multifidi musculature. An active course of spinal therapy to specifically retrain the multifidi may decrease postoperative low back pain resulting from weakness associated with muscular insult.

Conclusions: Postoperative trunk muscle performance is dependent on the muscle retraction time. Thus, it is beneficial to shorten the retraction time to minimize back muscle injury and subsequent postoperative low back pain.