Grushina T I, Titov A A
Moscow Centre for Research & Practice in Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russia.
Vopr Kurortol Fizioter Lech Fiz Kult. 2021;98(6):28-32. doi: 10.17116/kurort20219806128.
The vertebral hemangioma (VH) and vertebrogenic pain syndromes of other etiologies are currently not a problem in terms of the choice of treatment method. However, the combination of these conditions makes the situation much more challenging. The question of the safety of physical treatment methods in these patients remains open, since there is no scientific evidence in this area.
To study the long-term results of electrotherapy, magnet therapy, lazer therapy, therapeutic exercises (TE), and therapeutic massage (in different combinations) in patients with degenerative-dystrophic processes of the spine and nonaggressive VH.
The study included 104 patients (75 females, 29 males) with degenerative-dystrophic processes of the spine and non-aggressive VH. The time between the treatment course and follow-up examination was 12 months.
VHs remained unchanged in 86.5% of patients. An increase in size was noted in 13.5%. In no case did the VH become aggressive. After the TE course, the rate of VH size increase was 10.8%. The combination of TE with massage and electrotherapy (including a combination of all methods) resulted in an increase in VH size in 17.9, 20.0, 23.8% of cases, respectively. When magnet therapy was used, an increase in VH size was recorded significantly less frequently (=0.021). No differences in the rate of VH size increase depending on sex, age (40-70 years), localization, and size were observed. In case of multiple VHs, the rate of growth was 23.1.
A limitation of the study was the relatively small number of patients, which could, in some cases, affect the correctness of statistical data. Nevertheless, there is a general trend of the effect of physical treatments on the course of non-aggressive VH in patients with vertebrogenic pain syndromes. Such patients may be recommended low-frequency low-intensity electro- and magnet therapy, therapeutic back massage, and TE.
目前,就治疗方法的选择而言,椎体血管瘤(VH)和其他病因引起的脊椎源性疼痛综合征并非难题。然而,这些病症的合并存在使情况变得更具挑战性。由于该领域缺乏科学证据,物理治疗方法在这些患者中的安全性问题仍未解决。
研究电疗、磁疗、激光治疗、治疗性运动(TE)和治疗性按摩(不同组合)对患有脊柱退行性营养不良性病变和非侵袭性VH患者的长期效果。
该研究纳入了104例患有脊柱退行性营养不良性病变和非侵袭性VH的患者(75例女性,29例男性)。治疗疗程与随访检查之间的时间为12个月。
86.5%的患者VH保持不变。13.5%的患者VH大小有所增加。VH在任何情况下均未变为侵袭性。TE疗程后,VH大小增加率为10.8%。TE与按摩及电疗联合(包括所有方法联合)分别导致17.9%、20.0%、23.8%的病例VH大小增加。使用磁疗时,VH大小增加的记录明显较少(=0.021)。未观察到VH大小增加率在性别、年龄(40 - 70岁)、部位和大小方面存在差异。对于多发VH病例,生长率为23.1。
该研究的一个局限性是患者数量相对较少,这在某些情况下可能影响统计数据的准确性。尽管如此,物理治疗对脊椎源性疼痛综合征患者非侵袭性VH病程的影响存在总体趋势。此类患者可推荐采用低频低强度电疗和磁疗、背部治疗性按摩以及TE。