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益生菌制剂对脊柱及椎旁肌术后恢复的研究进展
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Abstract:
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.
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