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腰椎间盘突出症的胶原蛋白治疗——一项初步研究。给药途径重要吗?

Collagen Therapy in Lumbar Spondylosis - a Pilot Study. Does the Route of Administration Matter?

作者信息

Godek Piotr

机构信息

Sutherland Medical Center, Warszawa, Polska / Sutherland Medical Center, Warsaw, Poland.

出版信息

Ortop Traumatol Rehabil. 2019 Dec 31;21(6):427-436. doi: 10.5604/01.3001.0013.7400.

Abstract

BACKGROUND

To compare the effectiveness of three techniques of collagen injection in the treatment of low back pain (LBP) in lumbar spondylosis.

MATERIAL AND METHODS

In this randomized prospective study, 30 patients with lumbar spondylosis were assigned to 3 groups: subcutaneous (Group A, n = 10), periradicular (Group B, n = 10) and epidural (Group C, n = 10). Collagen injections were administered once a week (4 injections in total). Assessment involved a visual pain scale (VAS) (0-10), Oswestry scale (0-50), Laitinen scale (0-16) and One Leg Stance Test (OLST) - time to onset of pain in the support limb. Patients were assessed at the start of treatment (W0), on completion of treatment (W1) and 1 month after completion of treatment (W2).

RESULTS

Improvement was seen with all three techniques of collagen administration. The minimal clinically important difference (MID) of 3 points on the VAS scale was noted in 44% of patients in Group A, 40% of patients in Group B and 60% of Group C. The MID for the Oswestry scale, determined at 10 points, was achieved in 56%, 50% and 20% of patients, respectively, while the MID for the Laitinen scale, determined at 4 points, was achieved in 56%, 30% and 40% of patients, respectively. All treated patients achieved the reference value of 30 seconds for OLST only in Group A.

CONCLUSION

Subcutaneous administration of collagen is not inferior in terms of effectiveness to periradicular and epidural injections in the treatment of LBP in lumbar spondylosis.

摘要

背景

比较三种胶原蛋白注射技术治疗腰椎间盘突出症所致下腰痛(LBP)的有效性。

材料与方法

在这项随机前瞻性研究中,30例腰椎间盘突出症患者被分为3组:皮下注射组(A组,n = 10)、神经根周围注射组(B组,n = 10)和硬膜外注射组(C组,n = 10)。每周注射一次胶原蛋白(共注射4次)。评估包括视觉疼痛量表(VAS)(0 - 10)、Oswestry量表(0 - 50)、Laitinen量表(0 - 16)和单腿站立试验(OLST)——支撑腿疼痛开始的时间。在治疗开始时(W0)、治疗结束时(W1)和治疗结束后1个月(W2)对患者进行评估。

结果

三种胶原蛋白给药技术均有改善。A组44%的患者、B组40%的患者和C组60%的患者在VAS量表上达到了3分的最小临床重要差异(MID)。Oswestry量表的MID确定为10分,分别有56%、50%和20%的患者达到,而Laitinen量表的MID确定为4分,分别有56%、30%和40%的患者达到。仅A组所有接受治疗的患者在OLST中达到了30秒的参考值。

结论

在治疗腰椎间盘突出症所致LBP方面,皮下注射胶原蛋白在有效性上不低于神经根周围注射和硬膜外注射。

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