ISICO (Italian Scientific Spine Institute), Milan, Italy.
Department of Biomedical, Surgical and Dental Sciences, University of Milan La Statale, Milan, Italy.
Eur Spine J. 2021 Oct;30(10):2962-2966. doi: 10.1007/s00586-021-06808-1. Epub 2021 Mar 17.
Adult scoliosis is sometimes associated with back pain and severe curves can progress over time. Despite scoliosis has been estimated to affect up to 68% of the population over 60, there is scant literature about conservative treatment for adult scoliosis. Recently, we tested a new brace designed to alleviate pain for adult patients with chronic pain secondary to scoliosis. The study aims to test the efficacy of a prefabricated brace in reducing pain in adult scoliosis patients.
Twenty adults (age 67.8 ± 10.5, curve 61.9 ± 12.6° Cobb) with chronic low back pain (cLBP) secondary to Idiopathic Scoliosis (IS) were included. Patients were evaluated at baseline immediately before starting with the brace and after 6 months. Outcome measures were GRS, Oswestry Disability Index (ODI), Roland Morris Questionnaire (RM), COMI. The paired t test, ANOVA and Wilcoxon tests were used for statistical analysis RESULTS: At six months, worst pain, leg pain and back pain were significantly improved: from 7.15 to 5.60, from 5.65 to 4.35 and from 6.55 to 5.25 (p < 0.05). Sixty-five percent of patients achieved the minimal clinically important difference of 2 points for worst pain and leg pain, 55% for back pain. RM and COMI improved (p < 0.05), no differences for ODI.
The prefabricated brace showed a significant improvement at 6 months of worst, leg and back pain in most patients in a group of adult women with IS and cLBP. The quality of life didn't change in a clinically significant way even if the patients reported satisfaction with the treatment. Trial registration number and date of registration: ClinicalTrials.gov Identifier: NCT02643290, December 31, 2015.
成人脊柱侧凸有时与背痛有关,严重的脊柱侧凸会随着时间的推移而进展。尽管据估计,60 岁以上人群中脊柱侧凸的发病率高达 68%,但关于成人脊柱侧凸的保守治疗方法的文献却很少。最近,我们测试了一种新的支具,旨在缓解因脊柱侧凸而导致慢性疼痛的成年患者的疼痛。本研究旨在测试预制支具在减轻成人脊柱侧凸患者疼痛方面的疗效。
20 名成年患者(年龄 67.8±10.5 岁,Cobb 角 61.9±12.6°)患有特发性脊柱侧凸(IS)继发的慢性下腰痛(cLBP)。患者在开始佩戴支具前即刻(基线)和 6 个月后进行评估。结果测量指标为 GRS、Oswestry 残疾指数(ODI)、Roland Morris 问卷(RM)、COMI。采用配对 t 检验、方差分析和 Wilcoxon 检验进行统计学分析。
6 个月时,最严重疼痛、腿痛和腰痛均显著改善:从 7.15 降至 5.60,从 5.65 降至 4.35,从 6.55 降至 5.25(p<0.05)。65%的患者在最严重疼痛和腿痛方面达到了 2 分的最小临床重要差异,55%的患者在腰痛方面达到了这一差异。RM 和 COMI 改善(p<0.05),ODI 无差异。
在一组患有特发性脊柱侧凸和慢性下腰痛的成年女性患者中,预制支具在 6 个月时显著改善了大多数患者的最严重疼痛、腿痛和腰痛。尽管患者对治疗表示满意,但生活质量并未以临床显著的方式改变。
ClinicalTrials.gov 标识符:NCT02643290,2015 年 12 月 31 日。