Calmels P, Fayolle-Minon I
Functional Rehabilitation and Readaptation Unit, Bellevue Hospital, Saint-Etienne, France.
Rev Rhum Engl Ed. 1996 Apr;63(4):285-91.
Orthoses are often used to treat lumbar spine disorders, although their indications have rarely been evaluated in clinical trials. We reviewed the literature for data on the effects of lumbar spine orthoses. Apart from bermuda corsets, restriction of intervertebral mobility seems limited at the most distal levels (L4-L5 and L5-S1). Restriction of extreme gross spinal motions can be achieved and is more marked for lateral bending than for forward bending or extension. Stiff corsets provide greater motion restriction than flexible corsets, although there are wide interindividual variations. Stiff orthoses are associated with decreased intradiscal pressure and increased intraabdominal pressure. Studies of the electrical activity of trunk muscles have produced conflicting data as a result of marked interindividual variability. In most studies, use of orthotic devices did not induce muscle wasting. Although lumbar spine orthoses are often prescribed with the goal of inducing analgesic, proprioceptive and preventive effects in the workplace, whether such effects are actually obtained, has not been adequately evaluated. Based on our literature review, we have drawn a list of the main indications for orthotic devices according to the desired effects in various disorders of the lumbar spine.
矫形器常用于治疗腰椎疾病，尽管其适应症在临床试验中很少得到评估。我们查阅了文献以获取有关腰椎矫形器效果的数据。除了百慕大式紧身胸衣外，在最远端节段（L4 - L5和L5 - S1），椎间活动度的限制似乎很有限。极端脊柱总体运动的限制是可以实现的，并且对于侧弯比对前屈或后伸更为明显。硬式紧身胸衣比软式紧身胸衣提供更大的运动限制，尽管个体差异很大。硬式矫形器与椎间盘内压力降低和腹内压力增加有关。由于个体差异显著，对躯干肌肉电活动的研究产生了相互矛盾的数据。在大多数研究中，使用矫形装置并未导致肌肉萎缩。尽管腰椎矫形器通常是为了在工作场所产生镇痛、本体感觉和预防作用而开具处方，但这些效果是否真的能实现尚未得到充分评估。基于我们的文献综述，我们根据腰椎各种疾病中预期的效果列出了矫形装置的主要适应症清单。
