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重度骨盆带疼痛患者的骨盆关节融合术——一项前瞻性单病例研究设计研究。

Pelvic joint fusion in patients with severe pelvic girdle pain - a prospective single-subject research design study.

作者信息

Kibsgård Thomas J, Røise Olav, Stuge Britt

机构信息

Department of Orthopaedics, Division of Surgery and Clinical Neuroscience, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway.

出版信息

BMC Musculoskelet Disord. 2014 Mar 15;15:85. doi: 10.1186/1471-2474-15-85.

Abstract

BACKGROUND

The fusion of the pelvic joints in patients with severe pelvic girdle pain (PGP) is a controversial and insufficiently studied procedure. The aims of this study were to evaluate physical function and pain after sacroiliac joint (SIJ) fusion.

METHODS

A single-subject research design study with repeated measurements was conducted; pre-operatively and at 3, 6 and 12 months post-operatively. The outcome measures considered were the Oswestry disability index (ODI), visual analogue scale (VAS), and SF-36. Eight patients with severe PGP received open-accessed unilateral anterior SIJ fusion and fusion of the pubic symphysis.

RESULTS

Seven patients reported positive results from the surgery. At 1 year post-operation, significant (p < 0.001) reductions in ODI (54 to 37) and VAS (82 to 57) were reported. The physical functioning, bodily pain, and social functioning scores in the SF-36 were also improved.

CONCLUSION

Positive and significant changes in disability and pain at 1 year after SIJ fusion were observed. Despite these positive results, open accessed anterior fusion of the SIJ was associated with adverse events and complications such as infection and nerve damage.

摘要

背景

严重骨盆带疼痛(PGP)患者的骨盆关节融合是一个存在争议且研究不足的手术。本研究的目的是评估骶髂关节(SIJ)融合术后的身体功能和疼痛情况。

方法

采用单受试者重复测量研究设计;在术前以及术后3个月、6个月和12个月进行测量。所考虑的结局指标包括Oswestry功能障碍指数(ODI)、视觉模拟量表(VAS)和SF-36。8例严重PGP患者接受了开放式单侧前路SIJ融合和耻骨联合融合术。

结果

7例患者报告手术结果为阳性。术后1年,ODI(从54降至37)和VAS(从82降至57)有显著(p < 0.001)降低。SF-36中的身体功能、身体疼痛和社会功能得分也有所改善。

结论

观察到SIJ融合术后1年残疾和疼痛有积极且显著的变化。尽管有这些积极结果,但开放式前路SIJ融合与感染和神经损伤等不良事件及并发症相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a184/3995535/c297639724d1/1471-2474-15-85-1.jpg

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