VA Puget Sound Health Care System, Tacoma, WA, USA.
Butler VA Health Care System, Butler, PA, USA.
Complement Ther Clin Pract. 2021 Feb;42:101261. doi: 10.1016/j.ctcp.2020.101261. Epub 2020 Nov 17.
Pain and disability may persist following lumbar spine surgery and patients may subsequently seek providers trained in manipulative and manual therapy (MMT). This systematic review investigates the effectiveness of MMT after lumbar surgery through identifying, summarizing, assessing quality, and grading the strength of available evidence. Secondarily, we synthesized the impact on medication utilization, and reports on adverse events.
Databases and grey literature were searched from inception through August 2020. Article extraction consisted of principal findings, pain and function/disability, medication consumption, and adverse events.
Literature search yielded 2025 articles,117 full-text articles were screened and 51 citations met inclusion criteria.
There is moderate evidence to recommend neural mobilization and myofascial release after lumbar fusion, but inconclusive evidence to recommend for or against most manual therapies after most surgical interventions. The literature is primarily limited to low-level studies. More high-quality studies are needed to make recommendations.
腰椎手术后可能仍存在疼痛和功能障碍，患者可能会寻求接受过手法和手动治疗（MMT）培训的医生。本系统评价通过确定、总结、评估质量和分级现有证据的强度，来研究腰椎手术后 MMT 的效果。其次，我们综合分析了药物使用和不良事件的影响。
从创建到 2020 年 8 月，对数据库和灰色文献进行了检索。文章提取包括主要发现、疼痛和功能/残疾、药物使用和不良事件。
文献检索得到 2025 篇文章，筛选出 117 篇全文文章，有 51 篇引文符合纳入标准。
有中度证据推荐在腰椎融合术后进行神经松动术和肌筋膜松解术，但对于大多数手术后干预措施，大多数手法治疗的推荐证据尚无定论。文献主要局限于低水平研究，需要更多高质量的研究来提供建议。
