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电磁场对伴有急性、严重胸腰椎间盘突出症的犬术后疼痛和运动功能恢复的影响:一项随机安慰剂对照、前瞻性临床试验。

The Effect of Electromagnetic Fields on Post-Operative Pain and Locomotor Recovery in Dogs with Acute, Severe Thoracolumbar Intervertebral Disc Extrusion: A Randomized Placebo-Controlled, Prospective Clinical Trial.

机构信息

1 Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University , Raleigh, North Carolina.

2 Department of Clinical Science and Services, Royal Veterinary College , Hatfield, United Kingdom.

出版信息

J Neurotrauma. 2018 Aug 1;35(15):1726-1736. doi: 10.1089/neu.2017.5485. Epub 2018 Apr 2.

Abstract

Spinal cord injury (SCI) attributed to acute intervertebral disc extrusions (IVDEs) is common in dogs and is treated by surgical decompression. Dogs with sensorimotor complete injuries have an incomplete recovery. Pulsed electromagnetic fields (PEMFs) reduce post-operative pain through anti-inflammatory effects and there is growing evidence for neuroprotective effects. This randomized, controlled clinical trial evaluated the effect of PEMF on post-operative pain and neurological recovery in dogs with surgically treated sensorimotor complete SCI attributed to acute IVDE. Sixteen dogs with surgically treated complete thoracolumbar SCI were randomized to receive PEMF (15 min every 2 h for 2 weeks then twice-daily for 4 weeks) or placebo starting immediately after diagnosis. The primary outcome was gait score at 2 weeks. Secondary measures of gait, pain perception, and proprioceptive function were evaluated at 2 and 6 weeks. Plasma glial fibrillary acidic protein (GFAP) concentration was measured as an SCI biomarker. Post-operative pain was quantified by measuring mechanical sensory thresholds (MSTs) at control and surgical sites. There was no significant difference in demographics or GFAP concentration between the two groups at trial entry. There was no difference in primary outcome or in secondary measures of gait, but proprioceptive placing was significantly better at 6 weeks and GFAP concentrations were significantly lower at 2 weeks in the PEMF group. MSTs were significantly higher in the PEMF-treated group. We conclude that PEMF reduced incision-associated pain in dogs post-surgery for IVDE and may reduce extent of SCI and enhance proprioceptive placing. Larger clinical trials are warranted.

摘要

脊髓损伤(SCI)归因于急性椎间盘突出(IVDE)在狗中很常见,通过手术减压治疗。具有感觉运动完全损伤的狗恢复不完全。脉冲电磁场(PEMF)通过抗炎作用减轻术后疼痛,并且神经保护作用的证据越来越多。这项随机对照临床试验评估了 PEMF 对手术治疗的急性 IVDE 引起的感觉运动完全性 SCI 犬术后疼痛和神经恢复的影响。16 只接受手术治疗的完全胸腰椎 SCI 犬被随机分为 PEMF 组(诊断后立即开始,每 2 小时接受 15 分钟治疗,持续 2 周,然后每天两次治疗,持续 4 周)或安慰剂组。主要结局是 2 周时的步态评分。在 2 周和 6 周时评估步态、疼痛感知和本体感觉功能的次要指标。测量神经胶质纤维酸性蛋白(GFAP)浓度作为 SCI 生物标志物。通过测量控制和手术部位的机械感觉阈值(MST)来量化术后疼痛。试验开始时,两组之间在人口统计学或 GFAP 浓度方面没有显着差异。主要结局或步态的次要测量没有差异,但本体感觉放置在 6 周时明显更好,PEMF 组在 2 周时 GFAP 浓度明显更低。PEMF 治疗组的 MST 明显更高。我们得出结论,PEMF 减轻了 IVDE 手术后狗与切口相关的疼痛,并且可能减少了 SCI 的程度并增强了本体感觉放置。需要更大规模的临床试验。

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