使用脊柱侧凸活动服的成人脊柱侧凸患者的疼痛和影像学改变:病例对照的10年随访结果

Mark W. Morningstar
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引用次数: 0

摘要

众所周知,成年患者的脊柱侧凸在整个生命周期中会增加,并且在成年后期会增加慢性疼痛的机会。成人脊柱侧凸的非手术治疗方案没有被广泛推荐,很大程度上是因为缺乏这方面的研究。成人的疼痛管理选择主要集中在治疗脊柱侧凸相关的疼痛,而不一定是脊柱侧凸本身,如硬膜外注射、处方止痛药和一般物理治疗。最近的研究报告了成人脊柱侧弯的非手术治疗方法令人鼓舞,但他们的研究设计限制了推断。目前的研究报告了穿着脊柱侧凸活动服至少10年的成年患者自我报告的疼痛和影像学结果。共选择22例符合纳入标准的患者图表进行审查。基线和10年随访时的Cobb角x线测量和自评四重数值疼痛评定量表(QVAS)作为结果。比较基线和10年的Cobb角测量值,并根据脊柱侧凸曲线类型细分。10年后,68%的患者的Cobb角改善了0.5°,总体平均约为9°。与基于已确定的成人线性进展率的10年科布角预测值相比,10年科布角测量值也观察到显著差异。在10年QVAS评分中也观察到统计学上显著的变化。这些结果表明脊柱侧凸活动服在改善成人Cobb角和减少脊柱侧凸相关疼痛方面的潜在作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pain and Radiographic Changes in Adult Scoliosis Patients Using a Scoliosis Activity Suit: Case-Controlled 10-Year Follow-Up Results
Scoliosis in adult patients is known to increase across the lifespan and increases the chance of chronic pain in later adulthood. Non-surgical scoliosis treatment options for adults are not widely recommended, largely due to lack of research in this area. Pain management options for adults are focused primarily on treating scoliosis-related pain, and not necessarily the scoliosis itself, such as epidural injections, prescription pain medications, and general physical therapy. Recent studies reporting non-surgical, scoliosis-specific treatment methods in adults are encouraging, but their study designs limit extrapolation. The current study reports the self-reported pain and radiographic outcomes in adult patients wearing a scoliosis activity suit for at least 10 years. A total of 22 patient charts that fulfilled the inclusion criteria were selected for review. Cobb angle radiographic measurements and self-rated quadruple numerical pain rating scale (QVAS) at baseline and 10-year follow-up were used as the outcomes. Cobb angle measurements were compared at baseline and 10 years and subdivided according to scoliosis curve pattern. At 10 years, 68% of patients had improvements in their Cobb angle > 5˚, with an overall average of approximately 9˚. Significant differences were also observed in the 10-year Cobb angle measurements when compared to the predicted 10-year Cobb angles based on the established rate of linear progression in adults. A statistically significant change was also observed in the 10-year QVAS scores. These results suggest a potential role of the scoliosis activity suit for improving Cobb angles in adults and reducing scoliosis-related pain.
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