Opara Józef, Dymarek Robert, Sopel Mirosław, Paprocka-Borowicz Małgorzata
Department of Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland.
Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, 50-367 Wroclaw, Poland.
J Clin Med. 2024 Aug 28;13(17):5112. doi: 10.3390/jcm13175112.
Injury of the spinal cord causes motor and sensory dysfunction as well as pathological reflexes, leading to paraplegia or tetraplegia. The sequelae of traumatic spinal cord injury (SCI) are a significant burden and impact on healthcare systems. Despite constant progress in medicine, traumatic SCI still remains irreversible. To date, no satisfying treatment that can enable neuronal regeneration and recovery of function at the damaged level has been found. Hundreds of experiments have been conducted on various possibilities of influencing spinal regeneration; some of them have yielded promising results, but unfortunately, the successes obtained in experimental animals have not translated into humans.
This narrative review article presents the application of extracorporeal shock wave therapy (eSWT) in patients with SCI. The article has been divided into parts: 1) use of extracorporeal shock wave therapy for regeneration of the spinal cord after traumatic spinal cord injury; 2) application of extracorporeal shock wave therapy in spasticity after spinal cord injury. In both cases, the hypotheses of possible mechanisms of action will be described.
A small number of clinical trials have demonstrated the potential of eSWT to influence the regeneration of the spine, as an innovative, safe, and cost-effective treatment option for patients with SCI. Some reports have shown that eSWT can improve spasticity, walking ability, urological function, quality of life, and independence in daily life.
脊髓损伤会导致运动和感觉功能障碍以及病理反射,进而引发截瘫或四肢瘫。创伤性脊髓损伤(SCI)的后遗症给医疗系统带来了沉重负担和影响。尽管医学不断进步,但创伤性SCI仍然是不可逆的。迄今为止,尚未找到能够实现神经元再生并恢复受损水平功能的令人满意的治疗方法。针对影响脊髓再生的各种可能性已经进行了数百项实验;其中一些取得了有前景的结果,但遗憾的是,在实验动物身上获得的成功尚未转化到人类身上。
这篇叙述性综述文章介绍了体外冲击波疗法(eSWT)在SCI患者中的应用。文章分为以下部分:1)体外冲击波疗法用于创伤性脊髓损伤后脊髓再生;2)体外冲击波疗法在脊髓损伤后痉挛中的应用。在这两种情况下,都将描述可能的作用机制假说。
少数临床试验证明了eSWT影响脊柱再生的潜力,对于SCI患者而言,它是一种创新、安全且具有成本效益的治疗选择。一些报告表明,eSWT可以改善痉挛、行走能力、泌尿功能、生活质量以及日常生活中的独立性。