No difference in long-term trunk muscle strength, cross-sectional area, and density in patients with chronic low back pain 7 to 11 years after lumbar fusion versus cognitive intervention and exercises
No difference in long-term trunk muscle strength, cross-sectional area, and density in patients with chronic low back pain 7 to 11 years after lumbar fusion versus cognitive intervention and exercises
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DOI：
10.1016/j.spinee.2011.06.004
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发表时间：
2011-08-01
期刊：
影响因子：
4.5
通讯作者：
Brox, Jens I.
中科院分区：
文献类型：
--
作者：
Froholdt, Anne;Holm, Inger;Brox, Jens I.
背景情况：腰椎融合术后1年观察到的肌肉强度和密度降低可能会在长期内恶化。目的：比较腰椎融合术和认知干预以及锻炼对慢性腰痛（CLBP）和椎间盘退变患者肌肉强度、横截面积、密度和自我评定功能的长期影响。随机对照研究，在8.5年时进行随访检查（范围，7-11岁）。患者和方法：CLBP和椎间盘退变患者随机接受两个下腰椎节段中的一个或两个的后外侧内固定融合术或3-包括每周认知干预和锻炼计划。等速肌力通过Cybex 6000（Cybex-Lumex，Inc.，Ronkonkoma，NY，USA）。所有患者之前都有试验程序的经验。测试背伸（E）和屈曲（F）肌肉，并计算E/F比值。通过计算机断层扫描测量L3-L4节段背部肌肉的横截面积和密度。患者评定其功能的一般功能Score.OUTCOME METHODS：躯干肌肉力量，横截面积，密度，和自我评价的functions.RESULTS：55例（90%）被纳入长期随访。两组之间在横截面积、密度、肌力或自我评定功能方面没有显著差异。认知干预和运动组显著增加躯干肌伸展（p
BACKGROUND CONTEXT: Reduced muscle strength and density observed at 1 year after lumbar fusion may deteriorate more in the long term.PURPOSE: To compare the long-term effect of lumbar fusion and cognitive intervention and exercises on muscle strength, cross-sectional area, density, and self-rated function in patients with chronic low back pain (CLBP) and disc degeneration.STUDY DESIGN: Randomized controlled study with a follow-up examination at 8.5 years (range, 7-11 years).PATIENTS AND METHODS: Patients with CLBP and disc degeneration randomized to either instrumented posterolateral fusion of one or both of the two lower lumbar levels or a 3-week cognitive intervention and exercise program were included. Isokinetic muscle strength was measured by a Cybex 6000 (Cybex-Lumex, Inc., Ronkonkoma, NY, USA). All patients had previous experience with the test procedure. The back extension (E) flexion (F) muscles were tested, and the E/F ratios were calculated. Cross-sectional area and density of the back muscles were measured at the L3-L4 segment by computed tomography. Patients rated their function by the General Function Score.OUTCOME MEASURES: Trunk muscle strength, cross-sectional area, density, and self-rated function.RESULTS: Fifty-five patients (90%) were included at long-term follow-up. There were no significant differences in cross-sectional area, density, muscle strength, or self-rated function between the two groups. The cognitive intervention and exercise group increased trunk muscle extension significantly (p