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当通过诊断性镇痛改善了引起跛行的疼痛时胸腰段骶部运动的改变

Alterations in thoracolumbosacral movement when pain causing lameness has been improved by diagnostic analgesia.

作者信息

Greve L, Dyson S, Pfau T

机构信息

Centre for Equine Studies, Animal Health Trust,Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK; Department of Clinical Science and Services, The Royal Veterinary College, University of London,Hawkshead Lane, North Mymms, Hatfield AL9 7TA, UK.

Centre for Equine Studies, Animal Health Trust,Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK.

出版信息

Vet J. 2017 Jun;224:55-63. doi: 10.1016/j.tvjl.2017.03.009. Epub 2017 May 3.

Abstract

Lameness, thoracolumbosacral pain and reduced range of motion (ROM) often coexist; better understanding of their relationship is needed. The objectives were to determine if thoracolumbosacral movement of horses changes when pain causing lameness is improved by diagnostic analgesia. We hypothesised that reduction of lameness will increase ROM of the thoracolumbosacral region. Thirteen horses with different types of hind limb lameness were trotted in straight lines and lunged on a 10m diameter circle on left and right reins before and after lameness was subjectively substantially improved by diagnostic analgesia. Inertial sensor data were collected from the withers, thirteenth (T13) and eighteenth thoracic (T18) vertebrae, third lumbar (L3) vertebra, tubera sacrale (TS), left and right tubera coxae. ROM of flexion-extension, axial rotation, lateral bending, dorsoventral, lateral-lateral motion and vertical movement symmetry were quantified at each thoracolumbar site. Hiphike difference (HHD), maximum difference (MaxDiff) and minimum difference (MinDiff) for the pelvic sensors were measured. Percentage changes for before and after diagnostic analgesia were calculated; mean±standard deviation (SD) or median [interquartile range] were determined. Associations between the change in pelvic versus thoracolumbar movement symmetry after each local analgesic technique were tested. After resolution of lameness, HHD decreased by 7% [68%] (P=0.006). The MinDiff decreased significantly by 33% [61%] (P=0.01), 45±13% (P=0.005) and 52±23% (P=0.04), for TS, L3 and T18, respectively. There was significantly increased ROM in flexion-extension at T13, in axial rotation at T13, T18, L3 and in lateral-lateral ROM at L3. Thoracolumbosacral asymmetry and reduced ROM associated with lameness were both altered immediately by improvement in lameness using diagnostic analgesia.

摘要

跛行、胸腰段疼痛和活动范围(ROM)减小常常并存;需要更好地了解它们之间的关系。目的是确定当通过诊断性镇痛改善导致跛行的疼痛时,马的胸腰段运动是否会发生变化。我们假设跛行的减轻将增加胸腰段区域的ROM。在通过诊断性镇痛使跛行在主观上显著改善之前和之后,13匹患有不同类型后肢跛行的马被直线小跑,并在直径为10米的圆圈上用左右缰绳进行绕圈运动。从鬐甲、第十三胸椎(T13)和第十八胸椎(T18)、第三腰椎(L3)、荐结节(TS)、左右髋结节收集惯性传感器数据。在每个胸腰段部位对屈伸、轴向旋转、侧屈、背腹、外侧-外侧运动和垂直运动对称性的ROM进行量化。测量骨盆传感器的臀高差异(HHD)、最大差异(MaxDiff)和最小差异(MinDiff)。计算诊断性镇痛前后的百分比变化;确定平均值±标准差(SD)或中位数[四分位间距]。测试了每种局部镇痛技术后骨盆与胸腰段运动对称性变化之间的关联。跛行缓解后,HHD降低了7%[68%](P = 0.006)。TS、L3和T18的MinDiff分别显著降低了33%[61%](P = 0.01)、45±13%(P = 0.005)和52±23%(P = 0.04)。T13的屈伸ROM、T13、T18、L3的轴向旋转ROM以及L3的外侧-外侧ROM均显著增加。使用诊断性镇痛改善跛行后,与跛行相关的胸腰段不对称和ROM减小均立即得到改变。

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