随着人口老龄化,骨质疏松性椎体压缩性骨折(OVCF)的发生率正在逐渐增加。尤其位于胸腰交界区的椎体,作为胸腰椎的连接点,躯体的负重应力集中于此,而且由于其活动度较大及其特殊的解剖结构从而使其间的椎体容易发生骨折。OVCF也正在成为...随着人口老龄化,骨质疏松性椎体压缩性骨折(OVCF)的发生率正在逐渐增加。尤其位于胸腰交界区的椎体,作为胸腰椎的连接点,躯体的负重应力集中于此,而且由于其活动度较大及其特殊的解剖结构从而使其间的椎体容易发生骨折。OVCF也正在成为一个日益严重的公共卫生问题,具有重大的社会经济影响。根据美国国家骨质疏松症基金会(美国)的数据,美国约有1000万人患有骨质疏松症,每年约有75万例OVCF,中国的骨质疏松症发病率与西方国家没有太大区别。急性和慢性疼痛以及进行性脊柱畸形的患者人数也在逐渐增加。目前有几种不同的治疗策略:保守治疗、传统手术和微创手术。治疗的选择取决于骨折的类型和治疗的目的。虽然2/3的患者会通过保守治疗逐渐好转,1/3的骨折患者会出现慢性疼痛。此外,椎体压缩性骨折还可能导致身高下降、脊柱后凸、肺功能下降、活动能力和平衡受损。在胸腰椎压缩性骨折的患者中,由于骨折的椎体仍然处于持续的压迫状态,导致周围的神经持续刺激,并导致长期疼痛。因此,对于胸腰椎压缩性骨折的患者,医生应选择合理的治疗方法,以避免进一步压迫骨折的脊椎,还应解决疼痛,恢复椎体高度并改善脊柱后凸、纠正脊柱后凸,并避免神经损伤,这一点十分重要。With the aging of the population, the incidence of osteoporotic vertebral compression fracture (OVCF) is gradually increasing. In particular, the vertebral bodies at the thoracolumbar junction, as the connection point between the thoracic and lumbar spine, bear the concentrated weight-bearing stress of the body. Moreover, due to their large range of motion and special anatomical structure, the vertebral bodies in this area are prone to fractures. OVCF is also becoming an increasingly serious public health problem with significant socioeconomic impacts. According to data from the National Osteoporosis Foundation (USA), approximately 10 million people in the United States suffer from osteoporosis, with about 750,000 cases of OVCF each year. The incidence of osteoporosis in China is not much different from that in Western countries. The number of patients with acute and chronic pain, as well as progressive spinal deformities, is also gradually increasing. Currently, there are several different treatment strategies: conservative treatment, traditional surgery, and minimally invasive surgery. The choice of treatment depends on the type of fracture and the treatment objective. Although two-thirds of patients will gradually improve through conservative treatment, one-third of fracture patients will experience chronic pain. In addition, vertebral compression fractures can also lead to a decrease in height, kyphosis, decline in lung function, and impairment of mobility and balance. In patients with thoracolumbar compression fractures, since the fractured vertebral body remains in a state of continuous compression, it causes continuous stimulation of the surrounding nerves and leads to long-term pain. Therefore, for patients with thoracolumbar compression fractures, it is very important that doctors should choose a reasonable treatment method to avoid further compression of the fractured vertebrae, relieve pain, restore vertebral height, improve the kyphosis, correct kyphosis, and avoid nerve damage.展开更多
腰椎管狭窄症在当今社会的发病率逐年增长,腰椎管狭窄症术后主要的恢复目标是缓解疼痛、改善神经功能和恢复腰椎稳定性。近年来,微创手术技术逐渐成为主流,因其对椎旁肌损伤小,术后恢复快。与此同时,益生菌作为一种新兴的治疗策略,在骨...腰椎管狭窄症在当今社会的发病率逐年增长,腰椎管狭窄症术后主要的恢复目标是缓解疼痛、改善神经功能和恢复腰椎稳定性。近年来,微创手术技术逐渐成为主流,因其对椎旁肌损伤小,术后恢复快。与此同时,益生菌作为一种新兴的治疗策略,在骨科疾病中的应用逐渐受到关注。益生菌通过调节肠道菌群、免疫系统和钙代谢,对骨骼健康产生积极影响。研究表明,益生菌可通过以下机制发挥作用:一是通过肠–肌轴改善肌肉质量和功能,延缓肌肉萎缩;二是通过肠–骨轴调节免疫细胞(如Treg、Th17)和细胞因子(如IL-10、IL-17),影响骨代谢,预防骨质疏松;三是通过调节肠道免疫平衡,减少炎症反应,从而减轻术后疼痛。在腰椎术后康复中,益生菌可能通过减轻术后炎症、促进肌肉恢复和改善骨代谢,发挥潜在的辅助作用。然而,目前关于益生菌在腰椎术后康复中的研究仍处于临床前阶段,人体研究数量有限且存在设计缺陷。未来需要开展更多高质量的人体临床试验,以验证益生菌在骨科领域的疗效和安全性。此外,深入探索益生菌的作用机制,如其对细胞受体的影响及其与其他器官系统的相互作用,也将为骨科治疗提供新的思路。The incidence of lumbar spinal stenosis (LSS) is increasing year by year in today’s society. The primary recovery goals after surgery for LSS are to relieve pain, improve neurological function, and restore lumbar spine stability. In recent years, minimally invasive surgical techniques have gradually become mainstream due to their minimal damage to paraspinal muscles and faster postoperative recovery. Meanwhile, probiotics, as an emerging therapeutic strategy, have increasingly attracted attention for their potential applications in orthopedic diseases. Probiotics exert positive effects on bone health by modulating the gut microbiota, immune system, and calcium metabolism. Studies have shown that probiotics can function through the following mechanisms: First, they improve muscle quality and function and delay muscle atrophy via the gut-muscle axis. Second, they regulate immune cells (such as Treg and Th17) and cytokines (such as IL-10 and IL-17) via the gut-bone axis, influencing bone metabolism and preventing osteoporosis. Third, they reduce inflammatory responses and alleviate postoperative pain by regulating gut immune balance. In the rehabilitation after lumbar surgery, probiotics may play a potential supportive role by reducing postoperative inflammation, promoting muscle recovery, and improving bone metabolism. However, research on the application of probiotics in postoperative lumbar rehabilitation is still in the preclinical stage, with limited and flawed human studies. More high-quality clinical trials are needed in the future to verify the efficacy and safety of probiotics in orthopedics. Additionally, exploring the mechanisms of action of probiotics, such as their effects on cell receptors and interactions with other organ systems, will provide new insights for orthopedic treatment.展开更多
文摘随着人口老龄化,骨质疏松性椎体压缩性骨折(OVCF)的发生率正在逐渐增加。尤其位于胸腰交界区的椎体,作为胸腰椎的连接点,躯体的负重应力集中于此,而且由于其活动度较大及其特殊的解剖结构从而使其间的椎体容易发生骨折。OVCF也正在成为一个日益严重的公共卫生问题,具有重大的社会经济影响。根据美国国家骨质疏松症基金会(美国)的数据,美国约有1000万人患有骨质疏松症,每年约有75万例OVCF,中国的骨质疏松症发病率与西方国家没有太大区别。急性和慢性疼痛以及进行性脊柱畸形的患者人数也在逐渐增加。目前有几种不同的治疗策略:保守治疗、传统手术和微创手术。治疗的选择取决于骨折的类型和治疗的目的。虽然2/3的患者会通过保守治疗逐渐好转,1/3的骨折患者会出现慢性疼痛。此外,椎体压缩性骨折还可能导致身高下降、脊柱后凸、肺功能下降、活动能力和平衡受损。在胸腰椎压缩性骨折的患者中,由于骨折的椎体仍然处于持续的压迫状态,导致周围的神经持续刺激,并导致长期疼痛。因此,对于胸腰椎压缩性骨折的患者,医生应选择合理的治疗方法,以避免进一步压迫骨折的脊椎,还应解决疼痛,恢复椎体高度并改善脊柱后凸、纠正脊柱后凸,并避免神经损伤,这一点十分重要。With the aging of the population, the incidence of osteoporotic vertebral compression fracture (OVCF) is gradually increasing. In particular, the vertebral bodies at the thoracolumbar junction, as the connection point between the thoracic and lumbar spine, bear the concentrated weight-bearing stress of the body. Moreover, due to their large range of motion and special anatomical structure, the vertebral bodies in this area are prone to fractures. OVCF is also becoming an increasingly serious public health problem with significant socioeconomic impacts. According to data from the National Osteoporosis Foundation (USA), approximately 10 million people in the United States suffer from osteoporosis, with about 750,000 cases of OVCF each year. The incidence of osteoporosis in China is not much different from that in Western countries. The number of patients with acute and chronic pain, as well as progressive spinal deformities, is also gradually increasing. Currently, there are several different treatment strategies: conservative treatment, traditional surgery, and minimally invasive surgery. The choice of treatment depends on the type of fracture and the treatment objective. Although two-thirds of patients will gradually improve through conservative treatment, one-third of fracture patients will experience chronic pain. In addition, vertebral compression fractures can also lead to a decrease in height, kyphosis, decline in lung function, and impairment of mobility and balance. In patients with thoracolumbar compression fractures, since the fractured vertebral body remains in a state of continuous compression, it causes continuous stimulation of the surrounding nerves and leads to long-term pain. Therefore, for patients with thoracolumbar compression fractures, it is very important that doctors should choose a reasonable treatment method to avoid further compression of the fractured vertebrae, relieve pain, restore vertebral height, improve the kyphosis, correct kyphosis, and avoid nerve damage.
文摘腰椎管狭窄症在当今社会的发病率逐年增长,腰椎管狭窄症术后主要的恢复目标是缓解疼痛、改善神经功能和恢复腰椎稳定性。近年来,微创手术技术逐渐成为主流,因其对椎旁肌损伤小,术后恢复快。与此同时,益生菌作为一种新兴的治疗策略,在骨科疾病中的应用逐渐受到关注。益生菌通过调节肠道菌群、免疫系统和钙代谢,对骨骼健康产生积极影响。研究表明,益生菌可通过以下机制发挥作用:一是通过肠–肌轴改善肌肉质量和功能,延缓肌肉萎缩;二是通过肠–骨轴调节免疫细胞(如Treg、Th17)和细胞因子(如IL-10、IL-17),影响骨代谢,预防骨质疏松;三是通过调节肠道免疫平衡,减少炎症反应,从而减轻术后疼痛。在腰椎术后康复中,益生菌可能通过减轻术后炎症、促进肌肉恢复和改善骨代谢,发挥潜在的辅助作用。然而,目前关于益生菌在腰椎术后康复中的研究仍处于临床前阶段,人体研究数量有限且存在设计缺陷。未来需要开展更多高质量的人体临床试验,以验证益生菌在骨科领域的疗效和安全性。此外,深入探索益生菌的作用机制,如其对细胞受体的影响及其与其他器官系统的相互作用,也将为骨科治疗提供新的思路。The incidence of lumbar spinal stenosis (LSS) is increasing year by year in today’s society. The primary recovery goals after surgery for LSS are to relieve pain, improve neurological function, and restore lumbar spine stability. In recent years, minimally invasive surgical techniques have gradually become mainstream due to their minimal damage to paraspinal muscles and faster postoperative recovery. Meanwhile, probiotics, as an emerging therapeutic strategy, have increasingly attracted attention for their potential applications in orthopedic diseases. Probiotics exert positive effects on bone health by modulating the gut microbiota, immune system, and calcium metabolism. Studies have shown that probiotics can function through the following mechanisms: First, they improve muscle quality and function and delay muscle atrophy via the gut-muscle axis. Second, they regulate immune cells (such as Treg and Th17) and cytokines (such as IL-10 and IL-17) via the gut-bone axis, influencing bone metabolism and preventing osteoporosis. Third, they reduce inflammatory responses and alleviate postoperative pain by regulating gut immune balance. In the rehabilitation after lumbar surgery, probiotics may play a potential supportive role by reducing postoperative inflammation, promoting muscle recovery, and improving bone metabolism. However, research on the application of probiotics in postoperative lumbar rehabilitation is still in the preclinical stage, with limited and flawed human studies. More high-quality clinical trials are needed in the future to verify the efficacy and safety of probiotics in orthopedics. Additionally, exploring the mechanisms of action of probiotics, such as their effects on cell receptors and interactions with other organ systems, will provide new insights for orthopedic treatment.
