太空飞行将宇航员置于能够诱发病理变化的多种环境中。在太空飞行期间和之后,脊柱的改变对宇航员的健康有重大影响。腰背痛是一种既定且常见的飞行中主诉。在该人群中,椎间盘突出的发生率较高,并且发病率很高。椎间盘内的形态学变化,椎体,和脊柱姿势肌肉影响整体脊柱功能和宇航员的表现。与太空飞行引起的病理有关的研究仍然很少,目前已有的评论广泛涉及中枢神经系统,而缺乏对脊髓功能的重视。
我们的目的是回顾和总结有关暴露于太空飞行后脊柱健康变化的现有数据,特别关注微重力的影响。作者还提出了有希望的诊断和治疗方法,其中神经外科医生可以积极影响宇航员的健康和飞行后的结果。
这篇综述中包含的文章是通过搜索引擎使用MEDLINE识别的,PubMed,Cochrane评论,谷歌学者,以及其他相关文章中的参考文献。搜索条件包括“脊柱和太空飞行”,“脊柱和太空飞行”,“椎间盘和太空飞行”,和“肌肉萎缩和太空飞行”,结果仅限于1961年至2020年的英文文章。酌情包括所选文章的参考文献。
这篇综述包括56篇文章。椎间盘的成分变化,椎骨,和椎旁肌肉会对太空中的宇航员脊柱功能产生不良影响,并导致飞行后的病理。椎间盘突出症的风险增加,特别是在飞行后恢复期间。在微重力条件下椎体退变可能会增加疝和骨折的风险。椎旁肌肉萎缩导致下背痛,脊柱健康状况较差,降低了稳定性。
微重力的解剖学变化有助于脊柱病变的发展。微重力影响感觉神经前庭功能,神经肌肉输出,基因表达,在其他系统中。成像和治疗干预的未来发展可能会更好地分析这些变化,并提供有针对性的治疗干预措施,以减轻该人群的疼痛和其他脊柱疾病的负担。
Spaceflight places astronauts in multiple environments capable of inducing pathological changes. Alterations in the spine have a significant impact on astronauts\' health during and after spaceflight. Low back pain is an established and common intra-flight complaint. Intervertebral disc
herniation occurs at higher rates in this population and poses significant morbidity. Morphological changes within intervertebral discs, vertebral bodies, and spinal postural muscles affect overall spine function and astronaut performance. There remains a paucity of research related to spaceflight-induced pathologies, and currently available reviews concern the central nervous system broadly while lacking emphasis on spinal function.
Our aim was to review and summarize available data regarding changes in spinal health with exposure to spaceflight, especially focusing on effects of microgravity. The authors also present promising diagnostic and treatment approaches wherein the neurosurgeon could positively impact astronauts\' health and post-flight outcomes.
Articles included in this review were identified via search engine using MEDLINE, PubMed, Cochrane
Review, Google Scholar, and references within other relevant articles. Search criteria included \"spine and spaceflight\", \"vertebral column and spaceflight\", \"vertebral disc and spaceflight\", and \"muscle atrophy and spaceflight\", with results limited to articles written in English from 1961 to 2020. References of selected articles were included as appropriate.
Fifty-six articles were included in this
review. Compositional changes at the intervertebral discs, vertebral bone, and paraspinal muscles contribute to undesirable effects on astronaut spinal function in space and contribute to post-flight pathologies. Risk of intervertebral disc
herniation increases, especially during post-flight recovery. Vertebral bone degeneration in microgravity may increase risk for
herniation and fracture. Paraspinal muscle atrophy contributes to low back pain, poorer spine health, and reduced stability.
Anatomical changes in microgravity contribute to the development of spinal pathologies. Microgravity impacts sensory neurovestibular function, neuromuscular output, genetic expression, among other systems. Future developments in imaging and therapeutic interventions may better analyze these changes and offer targeted therapeutic interventions to decrease the burden of pain and other diseases of the spine in this population.