Uso de ondas de choque radiales como cointervención en el manejo del síndrome de espalda fallida: un reporte de caso

Q4 Health Professions

Fisioterapia Pub Date : 2025-09-01 DOI:10.1016/j.ft.2025.05.002

I. Silva-Satlov, J. Stammer Acevedo, F. Aranguiz Salas, M. Venegas de la Paz

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Abstract

Background and objective

Failed back surgery syndrome (FBSS) is a complex condition characterized by persistent pain after spinal surgery. This study evaluates the effectiveness of radial shockwaves as a co-intervention in combination with conventional physiotherapy to improve pain and functionality in a case of FBSS.

Patient and method

A prospective, single-case study was conducted on a 62-year-old patient with pain and severe functional limitation, secondary to FBSS. During 14 sessions, manual therapy and therapeutic exercise were applied, incorporating radial shockwaves from the 5 th session onwards. These were administered in 2 phases: preparation (500 pulses at 1.5 bar and 14 Hz) and treatment (2000 pulses at 5 bar and 5 Hz), distributed bilaterally in the paravertebral musculature (T10-L5), quadratus lumborum, and painful points in the gluteal region. Pain was assessed using the visual analog scale, functionality with the Roland-Morris Questionnaire, and motor control with the modified Timed Up and Go test with accelerometer (inertial measurement unit).

Results

A total reduction in pain was observed (visual analog scale: 4.3 to 0) and an 81.25% improvement in functionality (Roland-Morris Questionnaire). The Timed Up and Go test reflected 24.67% less total time, an increase in step cadence, and a significant reduction in the sit-to-stand phase. The greatest changes coincided with the application of radial shockwaves.

Conclusion

Radial shockwaves, combined with physiotherapy, may be an effective co-intervention in the rehabilitation of patients with FBSS, optimizing the multimodal management of pain and functionality.

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利用放射状冲击波协助管理背痛失败：案例报告

背景与目的脊柱手术失败综合征（FBSS）是一种以脊柱手术后持续疼痛为特征的复杂疾病。本研究评估了桡骨冲击波联合常规物理治疗改善FBSS患者疼痛和功能的有效性。患者和方法对一名继发于FBSS的62岁疼痛和严重功能限制患者进行了一项前瞻性单病例研究。在14次会议期间，应用了手工疗法和治疗性运动，从第5次会议开始纳入径向冲击波。这些药物分两个阶段给药：准备阶段（500次脉冲，1.5巴和14赫兹）和治疗阶段（2000次脉冲，5巴和5赫兹），分布在双侧椎旁肌肉组织（T10-L5）、腰方肌和臀区痛点。疼痛评估采用视觉模拟量表，功能评估采用Roland-Morris问卷，运动控制评估采用加速度计（惯性测量单元）改进的Timed Up and Go测试。结果观察到疼痛总减轻（视觉模拟评分：4.3 ~ 0），功能改善81.25% （Roland-Morris问卷）。Timed Up and Go测试反映出总时间减少了24.67%，步伐节奏增加，从坐到站阶段显著减少。最大的变化与径向冲击波的应用一致。结论放射冲击波联合物理治疗可能是FBSS患者康复的有效联合干预手段，可优化疼痛和功能的多模式管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Fisioterapia Health Professions-Physical Therapy, Sports Therapy and Rehabilitation

CiteScore

0.50

自引率

0.00%

发文量

期刊介绍： Publicación Oficial de la Sociedad Española de Fisioterapeutas. Sus páginas ofrecen desde artículos originales hasta revisiones, pasando por el estudio de casos o los actos más importantes relacionados con la especialidad.