Pilates-based exercise in the treatment of a patient with persistent low back pain following transforaminal lumbar interbody fusion.

BACKGROUND: Low back pain (LBP) is the most commonly reported cause of disability in people under the age of 45 and is estimated to occur in 60-70% of the adult population in the industrialized world. This case report describes the use of Pilates-based exercise (PBE) in the physical therapy management of a patient with persistent chronic low back pain (CLBP) following transforaminal lumbar interbody fusion.

CASE DESCRIPTION: The patient was a 24-year-old female with a 7-year history of LBP presenting 17 months following surgery. The patient remained with constant LBP and right hip pain at 8/10 on the Numeric Pain Rating Scale (NPRS) after completing a course of physical therapy following the lumbar fusion.

OUTCOMES: The PBE intervention lasted for 22 sessions during which the patient demonstrated complete resolution of right hip pain and remained with intermittent LBP (2/10 NPRS) at discharge. Minimally Clinically Important Difference levels for all self-reported outcome measure instruments were exceeded at discharge. The patient returned to work with lifting restrictions.

DISCUSSION: Patients following spine surgery are often excluded in studies of spine stabilization and PBE interventions. This case report describes the use of PBE in the treatment of a patient following spine fusion. Research to elucidate the impact of PBE on patients with CLBP is needed.