腰背部肌功能锻炼维持退变性脊柱侧弯患者矫形效果的作用研究  

Role of lumbar muscle function exercise in maintaining the correction effect of degenerative scoliosis patients

作　　者：邱思 殷翔 罗科宇 王腾羽 赵建华 Qiu Si;Yin Xiang;Luo Keyu;Wang Tengyu;Zhao Jianhua(Department of Orthopedics,Army Medical Center of Army Medical University,Chongqing 400042,China)

机构地区：[1]陆军军医大学陆军特色医学中心骨科,重庆400042

出　　处：《保健医学研究与实践》2024年第2期76-80,共5页Health Medicine Research and Practice

基　　金：国家自然科学基金青年科学基金项目(82002308)。

摘　　要：目的探讨规律、有效的腰背部肌肉功能锻炼在退变性脊柱侧弯接受长节段固定和融合矫形术患者中的应用价值,以期为临床治疗提供参考。方法回顾性分析2018年1月—2021年12月在陆军特色医学中心脊柱外科诊断为退行性脊柱侧弯并接受长节段固定和融合术的89名患者的临床资料。根据患者是否按照医师指导的腰背肌康复锻炼方式(飞燕动作)进行功能锻炼达到1年,将患者分为锻炼组(n=40例)、非锻炼组(n=49例)。比较2组患者术前、术后2 d和术后1年骨盆[骨盆倾斜角(PT)和骶骨倾斜角(SS)]、矢状面参数[胸腰段后凸角(TLK)、腰椎前凸角(LL)、矢状位垂直偏距(SVA)、胸椎后凸角(TK)和近端交界区后凸角(PJA)]以及Oswestry残疾指数(ODI)、日本骨科协会评估治疗分数(JOA)、视觉模拟评分法(VAS)评分。结果术前及术后2 d时,2组患者LL、SVA、TLK、TK、PJA比较,差异无统计学意义(P>0.05)。术后1年,锻炼组患者SVA、TLK、TK、PJA小于非锻炼组,差异均有统计学意义(P<0.05)。术前及术后2 d时,2组患者SS、PT比较,差异无统计学意义(P>0.05)。术后1年时,锻炼组患者SS大于非锻炼组,而PT小于非锻炼组,差异均有统计学意义(P<0.05)。术后1年时,锻炼组患者ODI指数和VAS评分均低于非锻炼组,差异均有统计学意义(P<0.05),而2组患者JOA评分没有统计学意义(P>0.05)。结论长期、规律的腰背肌功能锻炼可以有效维持退变性脊柱侧弯患者在长节段固定和融合矫形术后矢状面的平衡效果。建议此类患者术后进行规律、有效的腰背肌功能锻炼,以降低脊柱侧弯矫形术后脊柱矢状面失衡的发生率。Objective This paper aims to explore the application of regular and effective lumbar muscle function exercise in patients undergoing long-segment fixation and fusion correction surgery for degenerative scoliosis,in order to provide evidence for clinical treatment.Methods A retrospective analysis was conducted on 89 patients diagnosed with degenerative scoliosis and undergoing long-segment fixation and fusion surgery at the Army Medical Center from January 2018 to December 2021.Based on whether the patients performed functional exercises for the lumbar muscles(swallow movements)as instructed by the physician for one year,the patients were allocated to an exercise group(n=40)and a non-exercise group(n=49).The pelvic parameters[pelvic tilt(PT)and sacral slope(SS)],sagittal plane parameters[thoracolumbar kyphosis(TLK),lumbar lordosis(LL),sagittal vertical axis(SVA),thoracic kyphosis(TK),and proximal junctional angle(PJA)],as well as the Oswestry Disability Index(ODI),Japanese Orthopaedic Association(JOA)score,and Visual Analog Scale(VAS)score were compared between the two groups before surgery,2 days after surgery,and 1 year after surgery.Results Before and 2 days after surgery,no significant differences were found in LL,SVA,TLK,TK,and PJA between the two groups(P>0.05).One year after surgery,the exercise group had significantly lower values of SVA,TLK,TK,and PJA compared to the non-exercise group(P<0.05).Before and 2 days after surgery,no significant differences were observed in SS and PT between the two groups(P>0.05).One year after surgery,the exercise group had a significantly higher value of SS and a significantly lower value of PT compared to the non-exercise group(P<0.05).One year after surgery,the exercise group had significantly lower ODI scores and VAS scores compared to the non-exercise group(P<0.05),while no significant difference was noted in JOA scores between the two groups(P>0.05).Conclusion Long-term and regular lumbar muscle function exercise can effectively maintain the sagittal plane balance in pa

关 键 词：退变性脊柱侧弯 长节段固定和融合术 脊柱平衡 腰背部功能锻炼 

分 类 号：R682[医药卫生—骨科学]