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成人脊柱畸形的康复治疗

Rehabilitation in adult spinal deformity.

作者信息

Özyemişci Taşkıran Özden

机构信息

Department of Physical Medicine and Rehabilitation, Koç University School of Medicine, Istanbul, Turkey.

出版信息

Turk J Phys Med Rehabil. 2020 Mar 16;66(3):231-243. doi: 10.5606/tftrd.2020.6225. eCollection 2020 Sep.

Abstract

Adult spinal deformity causes significant health-related problems such as pain and disability in adults. Currently, there are several non-operative management strategies such as pain medications, physical modalities, exercises, bracing or interventional procedures. Specific exercises including strengthening of back and abdominal muscles, neuromuscular re-education for daily tasks, and active self-correction are vital to improve postural control and spinal stability. Bracing for a few hours a day can help reduce pain and provide spinal stability in adults. In case of severe disability and pain unresponsive to non-operative treatments, spinal fusion with instrumentation is an alternative. Postoperative rehabilitation can help to reduce pain and disability and improve return to activity or work. Protecting the spine early after surgery and timing of initiation of exercises with respect to osseointegration and bone remodeling phases are important principles of postoperative rehabilitation. In this review, rehabilitation in adult spinal deformity is discussed in the light of the literature.

摘要

成人脊柱畸形会引发严重的健康相关问题,如成人疼痛和残疾。目前,有多种非手术治疗策略,如止痛药物、物理治疗、运动、支具或介入手术。特定的运动,包括加强背部和腹部肌肉、针对日常任务的神经肌肉再训练以及主动自我矫正,对于改善姿势控制和脊柱稳定性至关重要。每天佩戴数小时支具有助于减轻疼痛并为成人提供脊柱稳定性。对于严重残疾且非手术治疗无效的疼痛情况,器械辅助下的脊柱融合术是一种选择。术后康复有助于减轻疼痛和残疾,并改善恢复活动或工作的情况。术后早期保护脊柱以及根据骨整合和骨重塑阶段确定开始运动的时机是术后康复的重要原则。在本综述中,将根据文献对成人脊柱畸形的康复进行讨论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6e4/7557622/f99e9110e9fc/TJPMR-2020-66-3-231-243-F1.jpg

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