Oxiplex 凝胶对腰椎间盘切除术患者术后疼痛强度、身体残疾和肌肉骨骼力量的早期和中期疗效

IF 0.7 Q4 CLINICAL NEUROLOGY Egyptian journal of neurosurgery Pub Date : 2024-06-17 DOI:10.1186/s41984-024-00266-9
Alireza Tabibkhooei, Maziar Azar, Mohsen Nabiuni, Javid Jahandideh, Mohsen Benam, Farid Qoorchi Moheb Seraj, Feizollah Ebrahimnia, Ali Moradi
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摘要

羧甲基纤维素/聚环氧乙烷又称 Oxiplex 凝胶,常用于腰椎间盘切除手术。其作用是覆盖手术部位,防止粘连,缓解疼痛和症状。然而,关于其对术后疼痛强度、残疾程度和肌肉骨骼状况整体改善的有益影响程度,目前仍存在争议。因此,本研究旨在评估在腰椎间盘突出症的腰椎椎板切除术中使用 Oxiplex 凝胶的优势和局限性。本研究对 56 名连续接受单侧腰椎间盘切除术的患者进行了随机对照试验。这些患者是根据其临床表现和影像学检查结果选择的。经过初步评估后,患者接受了椎板切除术或椎板切开术。手术后,患者被随机分配到干预组(接受 Oxiplex 凝胶治疗)或对照组。这一分配是通过电脑随机数字生成器完成的。对所有患者进行了手术前、手术后 3 个月和 6 个月的评估。在手术后的不同时间点,Oxiplex 凝胶组和对照组在根性疼痛和腰痛强度以及残疾评分方面没有明显差异(分别为 p = 0.336、p = 0.65 和 p = 0.336)。此外,在术后评估中,两组患者的性功能障碍或括约肌障碍发生率没有明显差异(分别为 p = 0.639 和 p = 0.15)。此外,两组患者在不同下肢条件下的术后神经肌肉评估结果也无明显差异。根据我们的研究结果,Oxiplex 凝胶并未改善单侧腰椎间盘切除术后的症状或肌肉骨骼力量。
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Early and midterm efficacy of oxiplex gel on postoperative pain intensity, physical disability, and musculoskeletal power in patients undergoing lumbar discectomy
Carboxymethylcellulose/polyethylene oxide, also known as Oxiplex gel, is commonly used during lumbar discectomy operations. It serves to cover the surgical site, preventing adhesions and providing relief from pain and symptoms. However, there is ongoing debate regarding the extent of its beneficial effects on postoperative pain intensity, level of disability, and overall improvement of musculoskeletal conditions. Therefore, the objective of this study is to evaluate the advantages and limitations of using Oxiplex gel in lumbar laminectomy procedures specifically for herniated discs. A randomized controlled trial was conducted on 56 consecutive patients who were candidates for unilateral lumbar discectomy on one lumbar surface. The patients were chosen based on their clinical manifestations and imaging findings. After the initial assessment, the patients underwent either laminectomy or laminotomy surgery. Following the surgery, the patients were randomly assigned to either the intervention group (receiving Oxiplex gel) or the control group. This assignment was done using a computerized random number generator. Assessments were conducted before the operation, as well as 3 and 6 months post-surgery for all patients. There was no significant difference found between the Oxiplex gel and control groups in terms of radicular and low back pain intensity, as well as disability scores, at different time points after surgery (p = 0.336, p = 0.65, and p = 0.336, respectively). Additionally, there were no significant differences found in the prevalence of sexual or sphincteric disorders between the two groups during postoperative assessments (p = 0.639 and p = 0.15, respectively). Furthermore, no significant differences were observed in the results of the postsurgical neuromuscular evaluation under different lower extremities conditions between the two groups. Based on our findings, it was observed that Oxiplex gel did not demonstrate any improvement in post-unilateral lumbar discectomy symptoms or musculoskeletal power.
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