Koçak Fatmanur Aybala, Tunç Hakan, Tomruk Sütbeyaz Serap, Akkuş Selami, Köseoğlu Belma Füsun, Yılmaz Ebru
Department of Physical Medicine and Rehabilitation, Medical Faculty of Ahi Evran University, Kırşehir, Turkey.
Department of Physical Medicine and Rehabilitation, Ankara Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Turkey.
Turk J Phys Med Rehabil. 2017 Feb 16;64(1):17-27. doi: 10.5606/tftrd.2017.154. eCollection 2018 Mar.
This study aims to compare the efficiency of conventional motorized traction (CMT) with non-surgical spinal decompression (NSD) using the DRX9000™ device in patients with low back pain associated with lumbar disc herniation (LDH).
Between March 2009 and September 2009, a total of 48 patients (29 females, 19 males; mean age 43.1±9.8 years; range, 18 to 65 years) were randomized into two groups. The first group (n=24) underwent CMT and the second group (n=24) underwent NSD for a total of 20 sessions over six weeks. The patients were evaluated before and after the treatment. Pain was assessed using the Visual Analog Scale (VAS), functional status using the Oswestry Disability Index (ODI), quality of life using the Short Form-36 (SF-36), state of depression mood using the Beck Depression Inventory (BDI), and the global assessment of the illness using the Patient's Global Assessment of Response to Therapy (PGART) and Investigator's Global Assessment of Response to Therapy (IGART) scales.
There was no significant difference in the evaluation outcomes before the treatment between the groups. However, a statistically significant decline was found in the VAS, ODI, and BDI scores after the treatment in both groups (all p<0.001). Except for two subgroups, no significant changes were observed in the SF-36 form. Assessment of "marked improvement" was globally most frequently reported one in both groups. No significant difference was observed in the evaluation outcomes after treatment between the groups.
Our study results show that both CMT and NSD are effective methods in pain management and functional status and depressive mood improvement in patients with LDH, and NSD is not superior to CMT in terms of pain, functionality, depression and quality of life.
本研究旨在比较传统电动牵引（CMT）与使用DRX9000™设备进行的非手术脊柱减压（NSD）对伴有腰椎间盘突出症（LDH）的腰痛患者的治疗效果。
在2009年3月至2009年9月期间，共有48例患者（29例女性，19例男性；平均年龄43.1±9.8岁；年龄范围18至65岁）被随机分为两组。第一组（n = 24）接受CMT治疗，第二组（n = 24）接受NSD治疗，为期六周，共20次治疗。在治疗前后对患者进行评估。使用视觉模拟量表（VAS）评估疼痛，使用Oswestry功能障碍指数（ODI）评估功能状态，使用简短健康调查问卷（SF-36）评估生活质量，使用贝克抑郁量表（BDI）评估抑郁情绪状态，并使用患者对治疗反应的整体评估（PGART）和研究者对治疗反应的整体评估（IGART）量表对疾病进行整体评估。
两组治疗前的评估结果无显著差异。然而，两组治疗后VAS、ODI和BDI评分均有统计学意义的下降（均p<0.001）。除两个亚组外，SF-36量表未观察到显著变化。两组中最常报告的整体评估结果均为“明显改善”。两组治疗后的评估结果无显著差异。
我们的研究结果表明，CMT和NSD都是治疗LDH患者疼痛管理、改善功能状态和抑郁情绪的有效方法，并且在疼痛、功能、抑郁和生活质量方面，NSD并不优于CMT。
