Konstantinovic Ljubica M, Kanjuh Zeljko M, Milovanovic Andjela N, Cutovic Milisav R, Djurovic Aleksandar G, Savic Viktorija G, Dragin Aleksandra S, Milovanovic Nesa D
Clinic for Rehabilitation, Medical School, Belgrade, Serbia.
Photomed Laser Surg. 2010 Aug;28(4):553-60. doi: 10.1089/pho.2009.2576.
The aim of this study was to investigate the clinical effects of low-level laser therapy (LLLT) in patients with acute low back pain (LBP) with radiculopathy.
Acute LBP with radiculopathy is associated with pain and disability and the important pathogenic role of inflammation. LLLT has shown significant anti-inflammatory effects in many studies.
A randomized, double-blind, placebo-controlled trial was performed on 546 patients. Group A (182 patients) was treated with nimesulide 200 mg/day and additionally with active LLLT; group B (182 patients) was treated only with nimesulide; and group C (182 patients) was treated with nimesulide and placebo LLLT. LLLT was applied behind the involved spine segment using a stationary skin-contact method. Patients were treated 5 times weekly, for a total of 15 treatments, with the following parameters: wavelength 904 nm; frequency 5000 Hz; 100-mW average diode power; power density of 20 mW/cm(2) and dose of 3 J/cm(2); treatment time 150 sec at whole doses of 12 J/cm(2). The outcomes were pain intensity measured with a visual analog scale (VAS); lumbar movement, with a modified Schober test; pain disability, with Oswestry disability score; and quality of life, with a 12-item short-form health survey questionnaire (SF-12). Subjects were evaluated before and after treatment. Statistical analyses were done with SPSS 11.5.
Statistically significant differences were found in all outcomes measured (p < 0.001), but were larger in group A than in B (p < 0.0005) and C (p < 0.0005). The results in group C were better than in group B (p < 0.0005).
The results of this study show better improvement in acute LBP treated with LLLT used as additional therapy.
本研究旨在探讨低强度激光疗法（LLLT）对急性下腰痛（LBP）伴神经根病患者的临床疗效。
急性LBP伴神经根病与疼痛、功能障碍以及炎症的重要致病作用相关。多项研究表明LLLT具有显著的抗炎作用。
对546例患者进行了一项随机、双盲、安慰剂对照试验。A组（182例患者）接受200mg/日尼美舒利治疗，并额外接受活性LLLT治疗；B组（182例患者）仅接受尼美舒利治疗；C组（182例患者）接受尼美舒利和安慰剂LLLT治疗。采用固定皮肤接触法在受累脊柱节段后方应用LLLT。患者每周治疗5次，共治疗15次，参数如下：波长904nm；频率5000Hz；平均二极管功率100mW；功率密度20mW/cm²，剂量3J/cm²；全剂量12J/cm²时治疗时间150秒。观察指标包括用视觉模拟量表（VAS）测量疼痛强度；用改良Schober试验测量腰椎活动度；用Oswestry功能障碍评分评估疼痛功能障碍；用12项简短健康调查问卷（SF - 12）评估生活质量。在治疗前后对受试者进行评估。使用SPSS 11.5进行统计分析。
在所有测量的观察指标上均发现有统计学显著差异（p < 0.001），但A组的差异大于B组（p < 0.0005）和C组（p < 0.0005）。C组的结果优于B组（p < 0.0005）。
本研究结果表明，将LLLT作为辅助治疗用于急性LBP时，改善效果更佳。
