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经皮神经电刺激治疗脊柱手术后急性术后疼痛:范围综述。

Transcutaneous electrical nerve stimulation for the treatment of acute postoperative pain following spine surgery: a scoping review.

出版信息

J Neurosurg Spine. 2024 Apr 12;41(1):97-104. doi: 10.3171/2024.1.SPINE231079. Print 2024 Jul 1.


DOI:10.3171/2024.1.SPINE231079
PMID:38608300
Abstract

OBJECTIVE: Given the ubiquity and severity of postoperative pain following spine surgery, developing adequate pain management modalities is critical. Transcutaneous electrical nerve stimulation (TENS) is a promising noninvasive modality that is well studied for managing postoperative pain following a variety of surgeries, but data on using TENS for pain management in the acute postoperative period of spine surgery are limited. Therefore, this review aimed to recapitulate the existing evidence for the use of TENS in postoperative pain management for spine surgery and explore the potential of this modality moving forward. METHODS: A scoping review was conducted according to 2020 PRISMA guidelines. Two independently operating reviewers then conducted a systematic search of PubMed, Embase, and Scopus databases to identify studies that reported the use of TENS for the treatment of acute postoperative pain following spine surgery. The following data were abstracted from included studies: study type, sample size, demographics, surgery details, comparison group, assessment parameters, timing of postoperative assessment, TENS technical characteristics, relevant findings, length of hospital stay, complications with TENS, and notable limitations. RESULTS: Nine hundred thirty-two publications were screened, resulting in 6 studies included in this review, all of which were prospective clinical trials. The publication dates ranged from 1980 to 2011. Spine surgery types varied; the most common was posterior lumbar interbody fusion. No studies evaluated pain control in cervical- or thoracic-only surgeries. All 6 studies evaluated the level of postoperative pain directly. Five of the 6 studies that directly examined postoperative pain reported lower levels of pharmacological analgesia usage in the TENS groups compared with controls, with 4 of these studies reporting this difference as statistically significant. Length of hospital stay was evaluated in 2 studies, both of which reported decreases in mean length of stay, but these differences were not significant. Notably, every study reported distinct TENS administration parameters while also reporting similar results. CONCLUSIONS: This review concludes that TENS is effective at reducing postoperative pain in spine surgery. Further investigation is needed regarding the optimal settings for TENS administration, as well as efficacy in the thoracic and cervical spine.

摘要

目的:鉴于脊柱手术后普遍存在且严重的术后疼痛,开发足够的疼痛管理方式至关重要。经皮神经电刺激(TENS)是一种很有前途的非侵入性方式,已广泛研究用于管理多种手术后的术后疼痛,但关于 TENS 在脊柱手术后急性术后疼痛管理中的应用数据有限。因此,本综述旨在回顾 TENS 在脊柱手术后疼痛管理中的现有证据,并探讨该方式的未来潜力。

方法:根据 2020 年 PRISMA 指南进行范围界定综述。然后,两名独立操作的审查员对 PubMed、Embase 和 Scopus 数据库进行了系统搜索,以确定报告 TENS 用于治疗脊柱手术后急性术后疼痛的研究。从纳入的研究中提取以下数据:研究类型、样本量、人口统计学、手术细节、对照组、评估参数、术后评估时间、TENS 技术特点、相关发现、住院时间、TENS 相关并发症和显著局限性。

结果:筛选出 932 篇论文,其中 6 项研究纳入本综述,均为前瞻性临床试验。发表日期范围为 1980 年至 2011 年。脊柱手术类型不同;最常见的是后路腰椎椎体间融合术。没有研究评估颈椎或胸椎手术的疼痛控制。所有 6 项研究均直接评估术后疼痛水平。直接检查术后疼痛的 6 项研究中有 5 项报告 TENS 组的药物镇痛使用率低于对照组,其中 4 项研究报告这种差异具有统计学意义。有 2 项研究评估了住院时间,都报告了平均住院时间的缩短,但这些差异没有统计学意义。值得注意的是,每项研究都报告了不同的 TENS 管理参数,同时也报告了相似的结果。

结论:本综述得出结论,TENS 可有效减轻脊柱手术后的术后疼痛。需要进一步研究 TENS 给药的最佳参数以及在胸腰椎的疗效。

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引用本文的文献

[1]
Effectiveness of physiotherapy interventions after cervical neurosurgery: systematic review and meta-analysis.

Ir J Med Sci. 2025-7-25

[2]
A Transcutaneous Randomized Pulsed Radiofrequency Application for Spine Pain Conditions: A Case Series.

J Funct Morphol Kinesiol. 2025-6-25

[3]
Narrative Review on Postoperative Pain Management Following Spine Surgery.

Neurospine. 2025-6

[4]
Optimization of Postoperative Opioids Use Following Spine Surgery.

Curr Pain Headache Rep. 2025-4-23

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