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严重脊柱侧弯继发慢性下腰痛的成人支具固定:前瞻性初步研究 6 个月结果。

Bracing adults with chronic low back pain secondary to severe scoliosis: six months results of a prospective pilot study.

机构信息

ISICO (Italian Scientific Spine Institute), Milan, Italy.

Department of Biomedical, Surgical and Dental Sciences, University of Milan La Statale, Milan, Italy.

出版信息

Eur Spine J. 2021 Oct;30(10):2962-2966. doi: 10.1007/s00586-021-06808-1. Epub 2021 Mar 17.

Abstract

PURPOSE

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.

METHODS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

试验注册号和注册日期

ClinicalTrials.gov 标识符:NCT02643290,2015 年 12 月 31 日。

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