早期神经松动术对微创椎间植骨融合术后根性疼痛复现的影响

Effect of early neurodynamic mobilization on the recurrence of sciatica after the minimally invasive surgery-transforaminal lumbar interbody fusion

目的·探讨微创经椎间孔椎间植骨融合术(MIS-TLIF)后早期进行神经松动术对减少根性疼痛症状复现的影响。方法·将54例行单节段MIS-TLIF的患者随机分为2组。治疗组28例,术后第1天开始进行神经松动术治疗;对照组26例,术后不进行神经松动术治疗。评价2组患者视觉模拟评分(VAS)和日本骨科学会下腰痛评分(JOA)。结果·术前和术后3个月2组VAS评分和JOA评分无显著性差异(P>0.05);术后第4天治疗组VAS评分显著低于对照组(P<0.05),JOA评分显著高于对照组(P<0.05)。结论·对MIS-TLIF后患者早期进行神经松动术干预有助于减少术后早期根性疼痛症状复现的发生率,是一种安全可靠的方法。

Objective· To investigate the effect of early neurodynamic mobilization on the recurrence of sciatica after the minimally invasive surgery transforaminal lumbar interbody fusion （MIS-TLIF）. Methods · Fifty-four patients who underwent MIS-TLIF were divided into treatment group （n=28） and control group （n=26）. The control group received conventional rehabilitation treatment, while the treatment group received neurodynamic mobilization every day after the first post-operative day. The score of visual analogue scale （VAS） and Japanese Orthopaedic Association （JOA） score were evaluated before and after the treatment. Results · There was no significant difference in the score of VAS or JOA between two groups before the treatment or three months after surgery （P〉0.05）. The score of VAS was significantly lower （P〈0.05）, and the JOA score was significantly higher （P〈0.05） in the treatment group than in the control group four days after surgery. Conclusion · The early neurodynamic mobilization is effective to decrease the recurrence rate of sciatica in patients underwent MIS-TLIF.