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脊柱手术后驾车:生物力学、恢复途径及法医学见解

Driving after spine surgery: biomechanics, recovery pathways, and medico-legal insights.

作者信息

Wang Chao, Zhi Yayuan, Wu Zhongjie

机构信息

Department of Orthopedics, Affiliated Hospital of Shaoxing University, Shaoxing, China.

Department of Emergency Intensive Care Unit, Affiliated Hospital of Shaoxing University, Shaoxing, China.

出版信息

J Orthop Surg Res. 2025 Apr 15;20(1):374. doi: 10.1186/s13018-025-05787-z.

DOI:10.1186/s13018-025-05787-z
PMID:40229857
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11998192/
Abstract

Returning to driving is a significant milestone for patients recovering from spine surgery, representing restored independence, mobility, and mental well-being. However, this decision involves numerous challenges, including biomechanical restrictions, the effects of pain management, cognitive recovery, patient-reported outcomes, and diverse medico-legal considerations. This review consolidates current evidence on recovery timelines, biomechanical factors, and the influence of medications on driving ability. It also examines the role of regional legal frameworks and professional guidelines in shaping decisions by both patients and surgeons. Additionally, it highlights interdisciplinary approaches to enhance post-operative care and discusses the broader relevance of these findings for other medical fields, proposing future research to advance understanding in this area.

摘要

对于接受脊柱手术康复的患者而言,重新开始驾驶是一个重要的里程碑,标志着恢复了独立性、行动能力和心理健康。然而,这一决定面临诸多挑战,包括生物力学限制、疼痛管理的影响、认知恢复、患者报告的结果以及各种医学法律考量。本综述汇总了关于恢复时间线、生物力学因素以及药物对驾驶能力影响的现有证据。它还审视了区域法律框架和专业指南在影响患者和外科医生决策方面所起的作用。此外,它强调了跨学科方法以加强术后护理,并讨论了这些发现对其他医学领域的更广泛相关性,提出了未来研究方向以增进对该领域的理解。

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本文引用的文献

1
Gabapentin in drugged driving investigations.加巴喷丁在药物驾驶调查中的应用。
J Forensic Sci. 2024 May;69(3):986-992. doi: 10.1111/1556-4029.15500. Epub 2024 Feb 25.
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Cervical spondylotic myelopathy and driving abilities: defining the prevalence and long-term postoperative outcomes using the Quality Outcomes Database.颈椎脊髓病和驾驶能力:使用质量结果数据库定义患病率和长期术后结果。
J Neurosurg Spine. 2024 Feb 16;40(5):630-641. doi: 10.3171/2023.11.SPINE23738. Print 2024 May 1.
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Are brake response times altered post CT-guided cervical spine nerve root injections?CT 引导下颈椎神经根注射后制动反应时间是否改变?
Br J Radiol. 2024 Mar 28;97(1156):834-837. doi: 10.1093/bjr/tqae034.
4
Preoperative opioid use and postoperative return to work following spinal surgery in workers' compensation settings: a systematic review and meta-analysis.术前阿片类药物使用与工人赔偿设定下脊柱手术后重返工作岗位:系统评价和荟萃分析。
Int J Surg. 2024 Mar 1;110(3):1781-1792. doi: 10.1097/JS9.0000000000001035.
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Recovery Kinetics After Cervical Spine Surgery.颈椎手术后的恢复动力学。
Spine (Phila Pa 1976). 2023 Dec 15;48(24):1709-1716. doi: 10.1097/BRS.0000000000004830. Epub 2023 Sep 19.
6
Return to Driving Is Safe 6 Weeks After Anterior Cervical Surgery for Symptomatic Cervical Degenerative Disc Disease.症状性颈椎退行性椎间盘疾病行前路颈椎手术后 6 周可安全驾驶。
Clin Spine Surg. 2023 Jun 1;36(5):E218-E225. doi: 10.1097/BSD.0000000000001430. Epub 2023 Jan 23.
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Licensed and Liable. Insurance, Road Regulations, and Driving After Hip and Knee Arthroplasty Surgery.
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Opioid deprescribing in patients with chronic noncancer pain: a systematic review of international guidelines.慢性非癌痛患者的阿片类药物减用:国际指南的系统评价。
Pain. 2023 Mar 1;164(3):485-493. doi: 10.1097/j.pain.0000000000002746. Epub 2022 Aug 9.
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Recovery Kinetics After Commonly Performed Minimally Invasive Spine Surgery Procedures.常见微创脊柱手术操作后的恢复动力学
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Differences in postoperative quality of life in young, early elderly, and late elderly patients undergoing surgical treatment for degenerative cervical myelopathy.接受退行性颈椎脊髓病手术治疗的年轻、老年早期和老年晚期患者术后生活质量的差异。
J Neurosurg Spine. 2022 Mar 11;37(3):339-349. doi: 10.3171/2022.1.SPINE211157. Print 2022 Sep 1.