裝置脊椎內固定器患者之軀幹功能

很多下背痛患者接受手術治療時脊椎常常會裝置內因定器。這類患者手術後的脊椎功能到目前為止一直不見相關報告。本研究之目的即利用客觀的評估方法評估這類患者手術後脊椎的活動度、活動速度及背肌與腹肌之肌力；另以問卷方式得知患者對手術後脊椎功能的滿意度。本研究是追蹤52位台大醫院骨科部2位資深醫師之患者；以腰稚活動測試儀(lumbar motion monitor)測驗腰椎三度空問的活動度及活動速度。以Cybex 6000 (TEF)等速肌力測試儀(isokinetic dynamometer)測驗脊椎之背肌與腹肌在0°秒，30°／秒，60°／秒，90°／秒，120°／秒等5種角速度下之力矩。另以86位年齡、身高、體重相仿的健康無背痛受試者為對照組，結果發現：活動度及活動速度以矢狀面(sagittal plane)喪失最多，尤其是速度方面，多數患者僅為健康者的30-40%。年齡大於50歲以上的女性患者，其脊椎在各方面的功能表現都較差，包括背肌、腹肌之快、慢速力矩、活動角度及活動角速度。本研究之結果讓大家瞭解：脊椎裝置內固定器之患者，手術後活動度及肌力之訓練確實有加強之必要。

關鍵字

脊椎；脊椎內固定器；力矩；活動度

並列摘要

After failure of conservative treatment, many lower back pain patients under went surgical procedures with spinal instrumentation. In the literature, there were few reports concerning the spinal function such as range of motion, angular velocity and trunk strength in this type of patient population. Fifty-two patients with spinal instrumentation were selected. Their spinal range of motion and angular velocity were assessed with lumbar motion monitor, and their peak torque of trunk flexor and extensor at various speed were evaluated with Cybex 6000 TEF isokinetic dynamometer. Eighty-six age matched healthy subjects without back pain served as a control group. This study showed the following results: 1.All patients showed a decrease in their spinal range of motion, angular velocity and peak torque of trunk flexor and extensor at various speeds. 2.The greatest reduction in lumbar function, both range of motion and peak torque, were found on the sagittal plane and at 120°/sec of the isokinetic testing speed. 3.Among all patients, females older than 50 years of age showed greatest lose in spinal function, an indication that the functional capacities in these patients were affected by both gender and age.

並列關鍵字

Spine ； Spinal instrumentation ； Peak torque ； Mobility

國際替代計量

裝置脊椎內固定器患者之軀幹功能

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