Pao Jwo-Luen, Yang Rong-Sen, Hsiao Chen-Hsi, Hsu Wei-Li
Institute of Biomedical Engineering, National Taiwan University, Taiwan ; Division of Orthopedic Surgery, Department of Surgery, Far Eastern Memorial Hospital, Taiwan.
Department of Orthopedics, National Taiwan University Hospital, Taiwan ; Department of Orthopedics, College of Medicine, National Taiwan University, Taiwan.
J Phys Ther Sci. 2014 Aug;26(8):1165-71. doi: 10.1589/jpts.26.1165. Epub 2014 Aug 30.
[Purpose] Lumbar fusion has been used for spinal disorders when conservative treatment fails. The minimally invasive approach causes minimal damage to the back muscles and shortens the postoperative recovery time. However, evidence regarding functional recovery in patients after minimally invasive lumbar spinal fusion is limited. The purpose of this study was to investigate how trunk control ability is affected after minimally invasive lumbar fusion surgery during the early postoperative phase. [Subjects and Methods] Sixteen patients and 16 age- and sex-matched healthy participants were recruited. Participants were asked to perform a maximum forward reaching task and were evaluated 1 day before and again 1 month after the lumbar fusion surgery. Center of pressure (COP) displacement, back muscle strength, and scores for the Visual Analog Scale, and Chinese version of the modified Oswestry Disability Index (ODI) were recorded. [Results] The healthy control group exhibited more favorable outcomes than the patient group both before and after surgery in back strength, reaching distance, reaching velocity, and COP displacement. The patient group improved significantly after surgery in all clinical outcome measurements. However, reaching distance decreased, and the reaching velocity as well as COP displacement did not differ before and after surgery. [Conclusion] The LBP patients with lumbar fusion surgery showed improvement in pain intensity 1 month after surgery but no improvement in trunk control during forward reaching. The results provide evidence that the back muscle strength was not fully recovered in patients 1 month after surgery and limited their ability to move their trunk forward.
[目的] 当保守治疗无效时，腰椎融合术已被用于治疗脊柱疾病。微创方法对背部肌肉造成的损伤最小，并缩短了术后恢复时间。然而，关于微创腰椎融合术后患者功能恢复的证据有限。本研究的目的是调查微创腰椎融合术后早期阶段患者的躯干控制能力是如何受到影响的。[对象与方法] 招募了16例患者和16名年龄及性别匹配的健康参与者。参与者被要求执行最大前伸任务，并在腰椎融合手术前1天和术后1个月再次进行评估。记录压力中心（COP）位移、背部肌肉力量、视觉模拟量表评分以及中文版改良奥斯维斯特里功能障碍指数（ODI）。[结果] 在背部力量、前伸距离、前伸速度和COP位移方面，健康对照组在手术前后均比患者组表现出更有利的结果。患者组在所有临床结局测量指标上术后均有显著改善。然而，前伸距离减小，且手术前后前伸速度和COP位移没有差异。[结论] 接受腰椎融合手术的下腰痛患者术后1个月疼痛强度有所改善，但前伸时躯干控制能力没有改善。结果表明，患者术后1个月背部肌肉力量未完全恢复，限制了他们向前移动躯干的能力。
