腰椎融合手术患者恐惧、疼痛和残疾的康复相关影响：一项系统评价和荟萃分析。
The Rehabilitation-Related Effects on the Fear, Pain, and Disability of Patients With Lumbar Fusion Surgery: A Systematic Review and Meta-Analysis.
作者信息
Cheng Haiyan, Liu Jing, Shi Lin, Hei Xiuxiu
机构信息
Department of Military Clinic Area, The No.901 Hospital of the Joint Logistics Support Unit of the Chinese People's Liberation Army, Hefei, China.
Department of Orthopaedics, Ezhou Central Hospital, Ezhou, China.
出版信息
Neurospine. 2023 Mar;20(1):278-289. doi: 10.14245/ns.2245056.528. Epub 2023 Mar 31.
OBJECTIVE
The lumbar fusion is an important surgery for the orthopedic diseases. The rehabilitation might improve the outcome of patients with lumbar fusion surgery. The rehabilitation-related effects can be revealed by a systemic review and meta-analysis of randomized clinical trials (RCTs). The purpose of this study is to clarify the rehabilitation effects in the patients with lumbar fusion surgery.
METHODS
We performed a systematic search and a meta-analysis for the RCT of rehabilitation treatment on the patients with lumbar fusion surgery. The comparison between rehabilitation treatment (including psychological rehabilitation, exercise, and multimodal rehabilitation) and typical treatment was performed to find if the rehabilitation treatment can improve the outcome after the lumbar fusion surgery. Fifteen studies of lumbar fusion patients under rehabilitation treatment and typical treatment were enrolled in a variety of rehabilitation modalities. The focused outcome was the rehabilitation-related effects on the fear, disability, and pain of patients after the lumbar fusion surgery.
RESULTS
Five hundred twenty-eight rehabilitation subjects and 498 controls were enrolled. The psychological-related rehabilitation showed a significant decrease in pain-related fear when compared to usual treatment. The multimodal rehabilitation can improve the disability outcome to a greater extent when compared to usual treatment. The multimodal rehabilitation seemed to have a more significantly positive effect to decrease disability after lumbar fusion surgery. In addition, the exercise and multimodal rehabilitation can relieve the pain after lumbar fusion surgery. The exercise rehabilitation seemed to have a more significantly positive effect to relieve pain after lumbar fusion surgery.
CONCLUSION
The rehabilitation might relieve the pain-related fear, disability, and pain after lumbar fusion surgery.
目的
腰椎融合术是治疗骨科疾病的一项重要手术。康复治疗可能会改善腰椎融合手术患者的预后。随机临床试验（RCT）的系统评价和荟萃分析可以揭示与康复相关的效果。本研究的目的是阐明腰椎融合手术患者的康复效果。
方法
我们对腰椎融合手术患者康复治疗的随机对照试验进行了系统检索和荟萃分析。对康复治疗（包括心理康复、运动和多模式康复）与传统治疗进行比较，以确定康复治疗是否能改善腰椎融合手术后的预后。15项关于接受康复治疗和传统治疗的腰椎融合患者的研究纳入了各种康复方式。重点观察指标是康复治疗对腰椎融合手术后患者恐惧、残疾和疼痛的相关影响。
结果
共纳入528名康复受试者和498名对照组。与常规治疗相比，心理相关康复显示与疼痛相关的恐惧显著降低。与常规治疗相比，多模式康复能在更大程度上改善残疾预后。多模式康复似乎对降低腰椎融合手术后的残疾有更显著的积极作用。此外，运动和多模式康复可以缓解腰椎融合手术后的疼痛。运动康复似乎对缓解腰椎融合手术后的疼痛有更显著的积极作用。
结论
康复治疗可能会缓解腰椎融合手术后与疼痛相关的恐惧、残疾和疼痛。
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