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脊髓刺激治疗腰椎手术失败综合征:对姿势和步态的影响——一项初步的三维生物力学研究

Spinal Cord Stimulation in Failed Back Surgery Syndrome: Effects on Posture and Gait-A Preliminary 3D Biomechanical Study.

作者信息

Brugliera L, De Luca A, Corna S, Bertolotto M, Checchia G A, Cioni M, Capodaglio P, Lentino C

机构信息

Istituto Auxologico Italiano, Unità di Riabilitazione Osteoarticolare, Ospedale S Giuseppe, Strada Cadorna 90, Piancavallo, Italy.

Laboratorio Analisi del Movimento Ospedale Santa Corona di Pietra Ligure, Viale 25 Aprile 38, 17027 Pietra Ligure, Italy.

出版信息

Pain Res Manag. 2017;2017:3059891. doi: 10.1155/2017/3059891. Epub 2017 Sep 25.

Abstract

We studied 8 patients with spinal cord stimulation (SCS) devices which had been previously implanted to treat neuropathic chronic pain secondary to Failed Back Surgery Syndrome. The aim of our study was to investigate the effects of SCS on posture and gait by means of clinical scales (Short Form Health Survey-36, Visual Analogue Scale for pain, and Hamilton Depression Rating Scale) and instrumented evaluation with 3D Gait Analysis using a stereophotogrammetric system. The latter was performed with the SCS device turned both OFF and ON. We recorded gait and posture using the Davis protocol and also trunk movement during flexion-extension on the sagittal plane, lateral bending on the frontal plane, and rotation on the transversal plane. During and 30 minutes after the stimulation, not only the clinical scales but also spatial-temporal gait parameters and trunk movements improved significantly. Improvement was not shown under stimulation-OFF conditions. Our preliminary data suggest that SCS has the potential to improve posture and gait and to provide a window of pain-free opportunity to optimize rehabilitation interventions.

摘要

我们研究了8例先前已植入脊髓刺激(SCS)装置以治疗继发于腰椎手术失败综合征的神经性慢性疼痛的患者。我们研究的目的是通过临床量表(健康调查简表-36、疼痛视觉模拟量表和汉密尔顿抑郁评定量表)以及使用立体摄影测量系统的3D步态分析进行仪器评估,来研究脊髓刺激对姿势和步态的影响。后者在脊髓刺激装置关闭和开启的情况下均进行。我们使用戴维斯协议记录步态和姿势,以及矢状面上屈伸、额状面上侧屈和横断面上旋转时的躯干运动。在刺激期间和刺激后30分钟内,不仅临床量表,而且时空步态参数和躯干运动都有显著改善。在刺激关闭的情况下未显示出改善。我们的初步数据表明,脊髓刺激有可能改善姿势和步态,并提供一个无疼痛机会的窗口,以优化康复干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c48/5632923/659ed5ffdb20/PRM2017-3059891.001.jpg

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