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手术后腰椎疼痛的整脊治疗:32例回顾性研究

Chiropractic management of postsurgical lumbar spine pain: a retrospective study of 32 cases.

作者信息

Kruse Ralph A, Cambron Jerrilyn

出版信息

J Manipulative Physiol Ther. 2011 Jul-Aug;34(6):408-12. doi: 10.1016/j.jmpt.2011.05.011.

Abstract

OBJECTIVE

Although chiropractic manipulation is commonly used for low back pain, applying this procedure to the patient with postlumbar spine surgery has not been adequately studied. The purpose of this retrospective chart review is to report on the results of chiropractic management (including Cox flexion distraction technique) of patients with postsurgical lumbar spine pain to determine the change in reported pain based on surgical type.

METHODS

Ten years of patient files from one chiropractic practice were electronically screened for lumbar spine surgery occurring before presenting for chiropractic care. Of the 58 patients with a postsurgical diagnosis, 32 files contained all pertinent components for this study including treatment with Cox flexion distraction manipulation (in addition to adjunct procedures) for at least 2 weeks and pretreatment and posttreatment pain measures using the Numeric Pain Scale (NPS) that ranged from 0 (no pain) to 10 (worst pain imaginable).

RESULTS

A change was observed in the mean pretreatment and posttreatment NPS pain scores of 6.4 to 2.3, a reduction of 4.1 of 10. The mean number of treatments was 14, with a range of 6 to 31. When stratified by surgical type, the mean change in pain was most remarkable in patients who underwent a surgery that combined lumbar discectomy, fusion, and/or laminectomy, with an average NPS pain reduction of 5.7 of 10. No adverse events were reported for any of these postsurgical patients.

CONCLUSIONS

The results of this study showed improvement for patients with low back pain subsequent to lumbar spine surgery who were managed with chiropractic care.

摘要

目的

尽管整脊手法常用于治疗腰痛,但将此方法应用于腰椎手术后的患者尚未得到充分研究。本回顾性病历审查的目的是报告整脊治疗(包括考克斯屈曲牵引技术)对腰椎手术后疼痛患者的治疗结果,以确定基于手术类型的报告疼痛变化。

方法

对一家整脊诊所十年的患者档案进行电子筛选,以查找在接受整脊治疗之前进行过腰椎手术的患者。在58例术后诊断患者中,32份档案包含了本研究的所有相关内容,包括使用考克斯屈曲牵引手法(除辅助程序外)治疗至少2周,以及使用数字疼痛量表(NPS)进行治疗前和治疗后的疼痛测量,该量表范围为0(无疼痛)至10(可想象的最严重疼痛)。

结果

观察到治疗前和治疗后NPS疼痛评分的平均值从6.4变为2.3,降低了10分中的4.1分。平均治疗次数为14次,范围为6至31次。按手术类型分层时,接受腰椎间盘切除术、融合术和/或椎板切除术联合手术的患者疼痛平均变化最为显著,NPS疼痛平均降低了10分中的5.7分。这些术后患者均未报告不良事件。

结论

本研究结果表明,接受整脊治疗的腰椎手术后腰痛患者病情有所改善。

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