Topalidou Anastasia, Tzagarakis George, Balalis Konstantine, Papaioannou Alexandra
Department of Orthopaedics and Traumatology, University Hospital of Heraklion, Faculty of Medicine, University of Crete, Heraklion, Greece.
Department of Anaesthesiology, University Hospital of Heraklion, Faculty of Medicine, University of Crete, Heraklion, Greece.
PLoS One. 2016 Aug 11;11(8):e0160213. doi: 10.1371/journal.pone.0160213. eCollection 2016.
The mobility of the spine and the change in the angle of the curvatures are directly related to spinal pain and spinal stenosis. The aim of the study was the evaluation of morphology and mobility of the spine in patients who were subjected to decompression and posterior fusion with pedicle screws. The treatment group consisted of 20 patients who underwent posterior fixation of lumbar spine (one and two level fusion). The control group consisted of 39 healthy subjects. Mobility and curvatures of the spine were measured with a non-invasive device, the Spinal Mouse. Pain was evaluated with the Visual Analogue Scale (VAS). The Oswestry Disability Index (ODI) and the SF-36 were used to evaluate the degree of the functional disability and the quality of life, respectively. The measurements were recorded preoperatively and at 3, 6 and 12 months postoperatively. The mobility of the lumbar spine in the sagittal plane increased (p = 0.009) at 12 months compared to the measurements at 3 months. The mobility of the thoracic spine in the frontal plane increased (p = 0.009) at 12 months compared to the preoperative evaluation. The results of VAS, ODI and SF-36 PCS improved significantly (p<0.001). The levels of fusion exhibited a strong linear correlation (r = 0.651, p = 0.002) with the total trunk inclination in the upright position. Although pain, quality of life and spinal mobility in the sagittal and frontal planes significantly improved in the treatment group, these patients still had limited mobility and decreased curves/angles values compared to control group.
脊柱的活动度以及曲度角度的变化与脊柱疼痛和椎管狭窄直接相关。本研究的目的是评估接受减压和椎弓根螺钉后路融合术患者的脊柱形态和活动度。治疗组由20例行腰椎后路固定术（单节段和双节段融合）的患者组成。对照组由39名健康受试者组成。使用非侵入性设备Spinal Mouse测量脊柱的活动度和曲度。采用视觉模拟评分法（VAS）评估疼痛程度。分别使用Oswestry功能障碍指数（ODI）和SF-36量表评估功能障碍程度和生活质量。在术前以及术后3个月、6个月和12个月记录测量结果。与术后3个月的测量结果相比，术后12个月腰椎矢状面活动度增加（p = 0.009）。与术前评估相比，术后12个月胸椎冠状面活动度增加（p = 0.009）。VAS、ODI和SF-36量表的生理健康评分（PCS）结果显著改善（p<0.001）。融合节段与直立位时躯干总倾斜度呈强线性相关（r = 0.651，p = 0.002）。尽管治疗组患者的疼痛、生活质量以及矢状面和冠状面的脊柱活动度显著改善，但与对照组相比，这些患者的活动度仍然受限，曲度/角度值降低。
