嚴重下背痛之預後

Outcome of Severe Low Back Pain

權啟良(Chii-Liang Chyuan) ； 黃美涓(May-Kuen Wong)

《中華民國復健醫學會雜誌》 18期 (1990/12) Pp. 163-170

摘要

下背痛常會給病人帶來生活上的不便，即便接受過治療，亦不免常有疼痛的復發，使得病人一再更換治療方式。本研究在探討嚴重下背痛患者，接受物理治療與手術治療結果的比較。
本研究收集因嚴重下背痛而住院治療共62例，其中男性41位，女性21位。平均年齡41.95±14.92歲。從疼痛開始至接受治療平均是22.5週。病因以椎間盤凸出症最多，佔66.6%。誘發疼痛因素則以搬重物為最多，佔44.2%。
45位接受物理治療者中，有40位獲得症狀改善，佔88.9%；另有17位接受手術治療，成功者亦高速94.1%。將兩組加以比較，發現在開始治療的時間、治療從疼痛分數的降低、日常生活活動分數及住院日的長短均無顯著差異。
本研究也發現，治療有效但日後症狀復發的患者，在物理治療組有20位，佔50%；手術治療組更高達12位，佔75%。因此如何減低下背痛復發比率則是值得進一步探討的重要課題。

並列摘要

Low back pain is a suffering condition which frequently results in limitation of activity of daily living. The frequent recurrence of low back pain makes patient accept different therapeutic tries. The purpose of this study was to compare the effects of physical therapy and surgical therapy for severe low back pain.
Sixty two patients who had been admitted to our departement of rehabilitation for severe low back pain were collected. Among Them, 41 were males. 21 were females. The major cause of low back pain was intervertebral disc herniation, about 66.6%. The most frequent precipitating factor of low back pain was lifting heavy object, about 44.2%.
The different causes and conditions of low back pain will result in many different type of management. They start to receive therapy in this hospital at 22.5 weeks in average after symptom onset. Forty patients were improved in physical therapy group (88.9%), while 16 cases got initially improvement in surgical group (94.1%). It was no significant difference in age, duration of symptom, pain score, activity of daily living score or hospitalizati on in both groups.
The frequent recurrence of low back pain trementdously bothered patients in both groups. The recurrent rate of low back pain in this study was 50% in physical therapeutic group, and 75% in surgical goup.
How to decrease the recurrent rate of low back pain is still a great challenge for medical personel.

並列關鍵字

Low back pain ； physical therapy ； surgical therapy ； recurrent rate