La Rocca Giuseppe, Orlando Vittorio, Galieri Gianluca, Mazzucchi Edoardo, Pignotti Fabrizio, Cusumano Davide, Bazzu Paola, Olivi Alessandro, Sabatino Giovanni
Institute of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy.
Neurosurgical Training Center and Brain Research, Mater Olbia Hospital, 07026 Olbia, Italy.
J Pers Med. 2024 Aug 29;14(9):917. doi: 10.3390/jpm14090917.
This study aimed to evaluate the efficacy of mindfulness therapy compared to traditional physiotherapy and usual care in alleviating postoperative pain and improving functional outcomes in patients undergoing lumbar spine surgery during the COVID-19 pandemic.
Ninety patients undergoing lumbar decompression and fusion (LDF) who presented persistent low back pain after surgery were prospectively followed for one year. They were randomly divided into three groups: mindfulness therapy, physiotherapy, and medical therapy. The primary outcome was the improvement of the Oswestry Disability Index (ODI) score postoperatively and at six months follow-up.
Both mindfulness and physiotherapy groups showed significant improvement in ODI scores compared to the control group, with mean variations of 10.6 and 11.6 points, respectively, versus 4.9 points in the control group. There was no significant difference between mindfulness and physiotherapy ( = 0.52), but both were superior to medical care ( < 0.0001 for physiotherapy and = 0.0007 for mindfulness).
This study demonstrated that mindfulness therapy is more effective than usual care in improving postoperative outcomes for patients undergoing lumbar spine surgery. In our cohort, its efficacy was comparable to that of physiotherapy, making it a viable alternative, especially when access to healthcare services is restricted, as seen during the COVID-19 pandemic. Future research should validate the findings of this study and examine the long-term effects on surgical patient populations.
本研究旨在评估在2019年冠状病毒病大流行期间，与传统物理治疗和常规护理相比，正念疗法在减轻腰椎手术患者术后疼痛和改善功能结局方面的疗效。
对90例行腰椎减压融合术（LDF）且术后持续存在下腰痛的患者进行了为期一年的前瞻性随访。他们被随机分为三组：正念疗法组、物理治疗组和药物治疗组。主要结局指标是术后及随访6个月时奥斯威斯利功能障碍指数（ODI）评分的改善情况。
与对照组相比，正念疗法组和物理治疗组的ODI评分均有显著改善，平均变化分别为10.6分和11.6分，而对照组为4.9分。正念疗法组与物理治疗组之间无显著差异（P = 0.52），但两者均优于药物治疗（物理治疗组P < 0.0001，正念疗法组P = 0.0007）。
本研究表明，正念疗法在改善腰椎手术患者术后结局方面比常规护理更有效。在我们的队列中，其疗效与物理治疗相当，使其成为一种可行的替代方法，尤其是在像2019年冠状病毒病大流行期间那样医疗服务受限的情况下。未来的研究应验证本研究的结果，并研究其对手术患者群体的长期影响。
