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术前适应性训练对腰椎间盘突出症腰椎融合手术术后结局的影响:一项回顾性分析

The Impact of Preoperative Adaptive Training on Postoperative Outcomes in Lumbar Spine Fusion Surgery for Lumbar Disc Herniation: A Retrospective Analysis.

作者信息

Lu Jiawei, Guo Kai, Liu Elaine Zhiqing, Braun Corben, Huang Yufeng, Wu Desheng

机构信息

Department of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.

Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.

出版信息

J Pain Res. 2024 Jan 5;17:73-81. doi: 10.2147/JPR.S442239. eCollection 2024.

Abstract

PURPOSE

Lumbar disc herniation, often treated with surgical decompression when conservative measures fail, presents challenges due to prolonged prone positioning in surgeries. This retrospective study evaluates the benefits of preoperative adaptive training to mitigate post-surgical physiological changes.

PATIENTS AND METHODS

A review of medical records from June 2021 to March 2023 identified 170 patients unresponsive to conservative treatments. Grouped into adaptive training and control groups based on historical data, the former had undergone exercises to prepare for surgery and postoperative changes. Vital signs and VAS scores were extracted from patient records to assess training impact.

RESULTS

The adaptive training group demonstrated stabilized vital signs intraoperatively, with a notable improvement in surgical exposure compared to the control group. However, there were no significant differences in operative time or blood loss between the groups. Additionally, postoperative VAS scores showed no significant improvement in the adaptive training group at follow-up intervals of 14 days, 1 month, and 3 months post-operation, compared to the control group.

CONCLUSION

Our study reveals that preoperative adaptive training stabilizes intraoperative blood pressure fluctuations in lumbar disc herniation surgeries. However, this stabilization does not significantly impact long-term postoperative pain management. This highlights the need for further research to explore comprehensive strategies that effectively combine preoperative training with postoperative care.

摘要

目的

腰椎间盘突出症在保守治疗失败时通常采用手术减压治疗,由于手术中需要长时间俯卧位,因此存在挑战。本回顾性研究评估术前适应性训练对减轻术后生理变化的益处。

患者与方法

回顾2021年6月至2023年3月的病历,确定了170例对保守治疗无反应的患者。根据历史数据分为适应性训练组和对照组,前者进行了为手术和术后变化做准备的练习。从患者记录中提取生命体征和视觉模拟评分(VAS)以评估训练效果。

结果

适应性训练组术中生命体征稳定,与对照组相比,手术视野有显著改善。然而,两组之间的手术时间和失血量没有显著差异。此外,与对照组相比,在术后14天、1个月和3个月的随访间隔中,适应性训练组的术后VAS评分没有显著改善。

结论

我们的研究表明,术前适应性训练可稳定腰椎间盘突出症手术中的血压波动。然而,这种稳定对术后长期疼痛管理没有显著影响。这突出表明需要进一步研究,以探索将术前训练与术后护理有效结合的综合策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/380c/10775701/36ec3d33bb09/JPR-17-73-g0001.jpg

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