| 李庆辉,俞仲翔,詹红生,赵咏芳,张琳聆,王辉昊.腰椎融合术后桩功训练对脊柱矢状位平衡参数影响的临床观察[J].中国康复,2026,41(7):414-418 |
| 腰椎融合术后桩功训练对脊柱矢状位平衡参数影响的临床观察 |
| Clinical observation of the effects of pile-standing exercise on spinal sagittal balance parameters following lumbar interbody fusion |
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| DOI：10.3870/zgkf.2026.07.006 |
| 中文关键词: 腰椎退行性变 脊柱矢状位平衡 桩功训练 功能训练 |
| 英文关键词: lumbar degenerative diseases spinal sagittal balance Zhan Zhuang training functional exercise |
| 基金项目:国家自然科学基金项目（82575085） |
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| 中文摘要: |
| 目的:观察桩功训练对腰椎融合术后患者脊柱矢状位平衡参数及腰椎功能的影响。方法：将68例腰椎融合术后患者随机分为对照组和观察组各34例，对照组采用术后常规功能训练，观察组采用站桩功训练。于干预前（术后1周）及干预12周后记录矢状位垂直轴（SVA）、骨盆倾斜角（PT）、骨盆入射角（PI）、骶骨倾斜角（SS）、胸椎后凸角（TK）及腰椎前凸角（LL），并以SVA为主要指标评估有效率；于干预前、干预后4周、8周及12周采用视觉模拟评分法（VAS）评估腰腿疼痛情况，采用Oswestry功能障碍指数（ODI）评分评估腰椎功能状态。结果：干预12周后，观察组SVA绝对值减小，对照组SVA绝对值增大（P＜0.01）；2组PT均增大（P＜0.01，0.05），观察组PT低于对照组（P＜0.01），2组SS、TK均增大（P＜0.05），观察组SS、TK高于对照组（P＜0.01）；2组PI组内及组间比较差异均无统计学意义；观察组LL增大（P＜0.01），对照组变化不显著，组间比较无统计学差异。干预后4、8、12周2组VAS评分及ODI均呈持续下降趋势（P＜0.05），且干预后4、8、12周观察组下肢VAS评分和ODI评分均低于对照组（P＜0.05），但腰部VAS评分仅在干预后4周观察组低于对照组（P＜0.01），干预后8周和12周组间比较差异无统计学意义。干预后12周，观察组有效率高于对照组（P＜0.05）。结论：在腰椎融合术后康复中，桩功训练相较于常规功能训练，能更好地维持脊柱矢状位平衡，增强平衡代偿能力，减轻术后疼痛，改善腰椎功能。 |
| 英文摘要: |
| Objective: To observe the effects of pile-standing exercise on spinal sagittal balance parameters and lumbar function in patients following lumbar fusion surgery.Methods: A total of 68 patients after lumbar fusion surgery were randomly divided into a control group (n=34) and an observation group (n=34). The control group received conventional postoperative functional exercise, while the observation group performed pile-standing exercise. Sagittal vertical axis (SVA), pelvic tilt (PT), pelvic incidence (PI), sacral slope (SS), thoracic kyphosis (TK), and lumbar lordosis (LL) were recorded before intervention (one week postoperatively, same below) and 12 weeks after intervention, with SVA as the primary indicator for evaluating effectiveness. Visual analogues scale (VAS) was used to assess low back and leg pain, and the Oswestry disability index (ODI) was used to evaluate lumbar functional status before intervention, and at 4, 8, and 12 weeks after intervention.Results: At 12 weeks post-intervention, the absolute value of SVA decreased significantly in the observation group but increased significantly in the control group (P<0.01). PT increased in both groups (control group P<0.01; observation group P<0.05), with the observation group showing a lower PT than the control group (P<0.01). Both SS and TK increased in the two groups (P<0.05), with higher values observed in the observation group than the control group (P<0.01). No statistically significant differences were found in PI within or between groups. LL increased significantly in the observation group (P<0.01), while no significant change was observed in the control group, and no statistical dif-ference was noted between groups. VAS scores and ODI showed a continuous decreasing trend in both groups at 4, 8, and 12 weeks post-intervention (P<0.05). Between-group comparisons revealed that the observation group had lower lower-limb VAS scores and ODI scores than the control group at 4, 8, and 12 weeks (P<0.05). However, for low back VAS scores, the observation group was lower than the control group only at 4 weeks (P<0.01), with no statistically significant differences at 8 and 12 weeks. At 12 weeks, the effectiveness rate was higher in the observation group than in the control group (P<0.05).Conclusion: In the rehabilitation following lumbar fusion surgery, pile-standing exercise, compared to conventional functional exercise, can better maintain spinal sagittal balance, enhance compensatory balance ability, alleviate postoperative pain, and improve lumbar function. |
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