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运动员的宫椎间盘置换:经过修改的德尔菲共识专家意见调查

Scott L Zuckerman¹, Jacob Jo², Grant H Rigney³

¹Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Orthopedic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.

The spine journal : official journal of the North American Spine Society

|May 8, 2025

概括

宫椎间盘置换 (CDR) 在高影响力运动员中可接受,但由于安全问题和缺乏数据,外科医生犹不决. 对于运动员骨髓病的CDR没有达成共识.

科学领域:

脊柱外科手术脊柱外科手术
运动医学运动医学
整形外科整形外科整形外科

背景情况:

在接触体育运动运动员中使用宫椎间盘置换 (CDR) 仍然存在争议,因为安全性和有效性数据不清楚.
现有的关于运动员CDR的研究,在回归体育 (RTS) 时间表和结果方面呈现出不同的结果.

研究的目的:

通过修改的Delphi共识调查,确定有关运动员使用宫椎间盘置换 (CDR) 的专家意见.
为了评估外科医生对RTS标准的共识,为运动员接受CDR治疗,以治疗各种椎疾病.

主要方法:

对34名专家脊椎外科医生组成的国际小组进行了一项横截式的,经过修改的Delphi共识调查.
外科医生对患有CDR的运动员评估了涉及RTS的场景,并根据影响和频率 (1-4级) 将运动分类.
共识被定义为关于CDR是否可接受以及何时可以建议RTS的≥70%的共识.

主要成果:

达成共识 (73.5%),CDR可用于高影响力运动员的一级宫基因病变,但只有58.8%的人会提供CDR.
在一级子宫疾病与带压缩/骨髓病 (47.1%) 中,对于CDR没有达成共识.
在手术后,57.6%的人建议在一级CDR后进行高冲击运动的RTS,而在两级CDR后是23.5%;时间表各不相同,游戏最常见的是3个月.

结论:

专家的共识支持CDR用于根性病变,但不是高影响力运动员的骨髓病变,尽管由于ACDF的确定性和安全问题,外科医生仍然犹不决.
运动员CDR应用存在显著的异质性,强调需要更多关于安全性,耐用性和长期疗效的数据.
进一步的研究对于在接触体育运动运动员中使用CDR和RTS协议的明确指南至关重要.

关键词:

关节质复原关节质复原关节质复原关节质复原运动员运动员运动员回到体育运动的回归脊柱外科手术脊柱外科手术完全更换磁盘的更换.

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