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发布者:鑫达医学翻译 发布时间:2012-05-22阅读:

原文
Object. Athletes present with back pain as a common symptom. Various sports involve repetitive hyperextension of the spine along with axial loading and appear to predispose athletes to the spinal pathology spondylolysis. Many athletes with acute back pain require nonsurgical treatment methods; however, persistent recurrent back pain may indicate degenerative disc disease or spondylolysis. Young athletes have a greater incidence of spondylolysis. Surgical solutions are many, and yet there are relatively few data in the literature on both the techniques and outcomes of
spondylolytic repair in athletes. In this study, the authors undertook a review of the surgical techniques and outcomes in the treatment of symptomatic spondylolysis in athletes.
Methods. A systematic review of the MEDLINE and PubMed databases was performed using the following key words to identify articles published between 1950 and 2011: “spondylolysis,” “pars fracture,” “repair,” “athlete,” and/ or “sport.” Papers on both athletes and nonathletes were included in the review. Articles were read for data on methodology (retrospective vs prospective), type of treatment, number of patients, mean patient age, and mean follow-up.
Results. Eighteen articles were included in the review. Eighty-four athletes and 279 nonathletes with a mean age of 20 and 21 years, respectively, composed the population under review. Most of the fractures occurred at L-5 in both patient groups, specifically 96% and 92%, respectively. The average follow-up period was 26 months for athletes and 86 months for nonathletes. According to the modified Henderson criteria, 84% (71 of 84) of the athletes returned to their sports activities. The time intervals until their return ranged from 5 to 12 months.
Conclusions. For a young athlete with a symptomatic pars defect, any of the described techniques of repair would probably produce acceptable results. An appropriate preoperative workup is important. The ideal candidate is younger than 20 years with minimal or no listhesis and no degenerative changes of the disc. Limited participation in sports can be expected from 5 to 12 months postoperatively.

译文
目的:由于运动员从事重复性脊柱伸展过度及轴向载荷运动,所以易出现脊椎滑脱。出现急性背疼的运动员多采用非手术疗法,但是,一旦出现持续或反复性背疼则有可能患有视乳头变性疾病或脊椎滑脱。其中,年轻运动员脊椎滑脱发病几率较高。当前,出现多种脊椎滑脱手术疗法,但少有研究对脊椎滑脱运动员的疗法及预后进行评价。本文对患有脊椎滑脱运动员的手术方法及预后进行评价。
方法:检索1950-2011年收录于MEDLINE及PubMed数据库的相关文献,检索所用关键词包括: “Spondylolysis(脊椎滑脱),” “pars fracture(椎弓骨折),” “repair(修复),” “athlete(运动员),”和/或 “sport(运动项目)”。以运动员及非运动员患者为研究对象的相关文献均纳入评价。 阅读相关文献,查看其所用方法(回顾性研究或前瞻性研究)、治疗方法、病例数、平均年龄及平均随访时间。
结果:共纳入18篇文献。 患者总数为363人,其中运动员病例84例,平均年龄为20周岁,非运动员病例279例,平均年龄为21周岁。两患者组的骨折多发于L-5水平,其中运动员组96%,非运动员组92%。前者平均随访周期为26个月,后者为86个月。 治疗后84%(71/84)名运动员间隔5-12个月后回到赛场。其能否继续比赛以修改的Henderson标准作为评价依据。
结论:针对文献报道的治疗方法,年轻脊椎滑脱运动员均取得了较好疗效。其中,术前准备尤为重要。疗效最佳的病例为年龄低于20周岁、轻度滑脱、无滑脱或无退行性病变患者。术后5-12个月后方可继续从事体育活动。


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