Gallien Philippe, Nicolas Benoît, Petrilli Sabine, Kerdoncuff Valérie, Lassalles Arnaud, Le Tallec Hélène, Durufle Aurélie
Service de Médecine Physique et Réadaptation, CHU Pontchaillou, rue Henri le Guillou, 35033 Rennes, France.
Joint Bone Spine. 2004 Jan;71(1):76-8. doi: 10.1016/S1297-319X(03)00124-6.
To report a case illustrating the usefulness of botulinum toxin A in the treatment of spinal dystonia responsible for low back pain and postural disorders.
Critical appraisal of a case report.
A young woman with cerebral palsy had lumbar paraspinal muscle dystonia responsible for pain and hyperlordosis unresponsive to oral medications for muscle spasm. Botulinum toxin A (Botox(R), 200 U) was injected into the paraspinal muscles at six sites, to good effect.
The few reported cases consistently show a favorable effect of local botulinum toxin A injections in patients with painful paraspinal muscle dystonia related to neurological disease or chronic low back pain.
Botulinum toxin A may be a useful treatment for incapacitating painful dystonia of the paraspinal muscles. This treatment improves posture in the sitting position and facilitates the fitting of orthotic devices. Furthermore, botulinum toxin A treatment may help to determine whether an intrathecal baclofen test is in order.
报告一例说明A型肉毒毒素在治疗导致腰痛和姿势障碍的脊柱肌张力障碍中的有效性的病例。
对一份病例报告进行批判性评估。
一名患有脑瘫的年轻女性出现腰部椎旁肌肌张力障碍，导致疼痛和腰椎前凸增加，对口服肌肉痉挛药物无反应。将A型肉毒毒素（保妥适®，200单位）注射到六个部位的椎旁肌，效果良好。
少数已报告的病例一致显示，局部注射A型肉毒毒素对患有与神经疾病或慢性腰痛相关的疼痛性椎旁肌肌张力障碍的患者有良好效果。
A型肉毒毒素可能是治疗使人丧失能力的疼痛性椎旁肌肌张力障碍的一种有效方法。这种治疗可改善坐姿并便于安装矫形器械。此外，A型肉毒毒素治疗可能有助于确定是否需要进行鞘内注射巴氯芬试验。
