舰载机飞行员脊柱骨折术后治疗并成功复飞1例报道

A carrier-based naval pilot with spinal fracture returned to flight work after surgical and rehabilitation treatment: A case report

  • 摘要:
      目的   通过分析我国首例舰载机飞行员脊柱骨折术后经过康复治疗成功复飞的案例,提出我军舰载飞行员脊柱康复的评估和治疗原则。
      方法   患者男性,35岁,舰载机飞行员,2016年4月因坠落导致L1脊柱椎体粉碎性骨折并多发骨挫伤,入住解放军总医院第六医学中心(原海军总医院),经过微创后路经椎弓根内固定、L1椎体经皮微创植骨手术,仍存在四肢、躯干活动障碍。后期康复治疗分为初、中、末三个阶段,包括了关节活动度(range of motion,ROM)、核心肌力、远端肌力、心肺功能、步态及职业能力的评估和治疗。
      结果   经过1年康复治疗结束后,患者已能完成6级腹桥,脊柱关节活动范围正常、心肺功能和动态步行等指标均显著提高,功能性动作测试(functional movement screen,FMS)评分33分。2017年3月经原海军、航天员中心、空军等多个机构专家鉴定,意见为飞行合格,并于2017年5月31日复飞成功。
      结论   经过三级康复,患者运动能力已达到球类运动员水平。故阶梯康复治疗可以应用在军事飞行员脊柱康复治疗中。

     

    Abstract:
      Objective  To summarize the experience of postoperative rehabilitation for carrier-based naval pilots with spinal fracture who have returned to flight mission successfully.
      Methods   The patient was a carrier-based naval aviator with age of 35 years who had vertebral collapse (L1) and multiple thoracolumbar contusion in April, 2016. After minimally invasive posterior transpedicular fixation and percutaneous bone grafting of L1 vertebral body, he still had dyskinesia. The rehabilitation consisted of three stages, and each stage included six main assessment categories and relevant training programs, such as range of motion (ROM), core strength, distal strength, cardiopulmonary function, gait parameters and occupational ability.
      Results   The treatment lasted for 1 year, and the patient was able to do plunk. Meanwhile, the ROM of spine, muscular strength, cardiopulmonary function index, gait parameters and occupational ability were all improved significantly. The total score of functional movement screen (FMS) was 33 points. On May 31, 2017, he returned to flight successfully after qualified by the Navy Certifying Commission, the Astronaut Center and the Air Force Research Institute.
      Conclusion   After three-stage rehabilitation, the patient's physical performance improves and reaches the level of ball game player, which suggests that the program of three-stage rehabilitation program can be used in spinal rehabilitation for fighter pilots.

     

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