目前治疗痉挛的技术及其有效性。

IF 4.3 2区 医学 Q1 ORTHOPEDICS
Hong-Xiao Li, Ke Xu, Shan-Lin Chen, Shu-Feng Wang, Wen-Jun Li
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引用次数: 0

摘要

本文综述了现有的痉挛治疗方法在降低肌张力和改善功能方面的作用。目前的手术方法主要有选择性背根切断术、选择性神经切断术、鞘内巴氯芬治疗(ITB)等。这些技术(除ITB外)可以长期降低患者的肌张力,并在一定程度上改善功能。年轻的手术,对侧C7神经转移和T1神经切开术,仍在研究中。ITB和非手术治疗方法,肉毒杆菌毒素A (BoNT-A)和体外冲击波治疗(ESWT),可以在短期内降低肌肉张力,但长期疗效不理想。此外,改善功能的效果也比较有争议。这些治疗方法的经济成本对患者来说也很沉重。此外,一些研究报道,某些电/磁刺激可以改善患者的功能。它们可能被用作痉挛的辅助治疗。根据目前的研究和我们自己的经验,考虑到患者的利益和成本效益,对于痉挛对其日常生活有重大不利影响的患者,仍然推荐手术方法(ITB除外)。目前关于痉挛治疗的研究也存在一些问题,如指南不完整,高质量的研究相对缺乏,这是医生需要努力的地方。需要进一步探索在改善患者功能的同时降低肌张力的治疗方法,更好地造福患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Current techniques for the treatment of spasticity and their effectiveness.

This review highlights the role of existing spasticity treatment methods in reducing muscle tone and improving function. The surgical methods today mainly include selective dorsal rhizotomy, selective neurotomy, intrathecal baclofen treatment (ITB), etc. These techniques (except ITB) can lower patients' muscular tone in the long term and improve function to some extent. The young procedures, contralateral C7 nerve transfer and T1 neurotomy, are still under research. ITB and nonsurgical treatment methods, botulinum toxin A (BoNT-A) and extracorporeal shockwave therapy (ESWT), can reduce muscle tone in the short term, but the long-term efficacy is unsatisfactory. In addition, the effects of improving function are relatively controversial. The economic cost of these treatment methods is also heavy for patients. In addition, some studies have reported that some kinds of electrical/magnetic stimulation can improve the patients' function. They can potentially be used as an adjunctive treatment for spasticity. According to current studies and our own experience, surgery methods (except ITB) are still recommended for patients, whose spasticity has a major detrimental influence on their everyday lives, taking into account patient benefits and cost-effectiveness. There are also some problems in the current research on spasticity treatment, such as incomplete guidelines and a relative lack of high-quality studies, which is what the doctors need to strive for. Further exploration is needed to find the treatment methods that can reduce muscle tone while improving patients' function to better benefit patients.

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来源期刊
Efort Open Reviews
Efort Open Reviews Medicine-Orthopedics and Sports Medicine
CiteScore
6.60
自引率
2.90%
发文量
101
审稿时长
13 weeks
期刊介绍: EFORT Open Reviews publishes high-quality instructional review articles across the whole field of orthopaedics and traumatology. Commissioned, peer-reviewed articles from international experts summarize current knowledge and practice in orthopaedics, with the aim of providing systematic coverage of the field. All articles undergo rigorous scientific editing to ensure the highest standards of accuracy and clarity. This continuously published online journal is fully open access and will provide integrated CME. It is an authoritative resource for educating trainees and supports practising orthopaedic surgeons in keeping informed about the latest clinical and scientific advances. One print issue containing a selection of papers from the journal will be published each year to coincide with the EFORT Annual Congress. EFORT Open Reviews is the official journal of the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) and is published in partnership with The British Editorial Society of Bone & Joint Surgery.
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