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腰椎间盘突出症突出髓核对硬膜囊机械作用的临床对照试验
Hits: 2565   Download times: 1359   Received:September 19, 2007    
作者Author单位UnitE-Mail
冯伟 FENG Wei 空军总医院,北京100036 General Hospital of Airforce,Beijing 100036,China fengwei@hotmail.com 
冯天有 FENG Tian-you 空军总医院,北京100036 General Hospital of Airforce,Beijing 100036,China  
王飞 WANG Fei 空军总医院,北京100036 General Hospital of Airforce,Beijing 100036,China  
毕永民 BI Yong-min 空军总医院,北京100036 General Hospital of Airforce,Beijing 100036,China  
期刊信息:《中国骨伤》2007年20卷,第12期,第803-804页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:全军杰出人才基金课题(编号:04J009)


目的:探讨腰椎间盘突出症突出髓核对硬膜囊机械作用的不同机制。

方法:观察腰椎间盘突出症患者38例(男20例,女18例;年龄21~51岁),根据患者MRI矢状位图像特点将突出髓核对硬膜囊的机械作用分为占位组和支撑组,采用脊柱(定点)旋转复位法治疗,测量并比较手法治疗前后两组患者椎间盘矢状径指数(SI)值及患侧直腿抬高角度。

结果:27例为占位组,11例为支撑组,治疗前椎间盘矢状径指数(SI)值两组间比较差异无统计学意义(P>0.05),患侧直腿抬高角度支撑组明显低于占位组(P<0.05)。治疗后两组患侧直腿抬高角度均显著提高(P<0.05),支撑组亦低于占位组(P<0.05)。治疗后两组患者椎间盘矢状径指数(SI)值无显著改变(P>0.05)。

结论:髓核压迫硬膜囊存在占位和支撑2种机制,作用机制不同可能是导致临床表现不同的原因之一。
[关键词]:腰椎  椎间盘移位  骨科疗法  临床对照试验  
 
The mechanical effect of herniated disk on the thecal sac in lumbar disk herniation and its clinical meanings
Abstract:

Objective:To discuss the different mechanism of the mechanical effect of herniated disk on the thecal sac.

Methods:Thirty-eight patients of lumbar disk herniation with the compressed thecal sac were divided into two groups(encroaching and straining group)according to the character of sagittal picture of MRI,all patients were treated by FENG Tian-you spinal manipulation.The degree of the straight leg rising(SLR) of the affected side and the sagittal index(SI) of lumbar disk were measured and analyzed before and after the treatment between two groups.

Results:There were 27 patients in encroaching group and 11 in straining group.The degree of SLR in straining group was lower than that of patients in encroaching group before treatment(P<0.05),but it increased a lot in both groups after treatment(P<0.05),while the degree of SLR of straining group was still low compared with encroaching group(P<0.05).There was no statistical difference of SI between the two groups both before and after treatment(P>0.05).

Conclusion:There exists two kinds of mechanism on the thecal sac compressed by herniated disk,which may lead to different clinical symptoms.
KEYWORDS:Lumbar vertebrae  Lumbar disk herniation  Orthopedic manipulation  Controlled clinical trials  
 
引用本文,请按以下格式著录参考文献:
中文格式:冯伟,冯天有,王飞,毕永民.腰椎间盘突出症突出髓核对硬膜囊机械作用的临床对照试验[J].中国骨伤,2007,20(12):803~804
英文格式:FENG Wei,FENG Tian-you,WANG Fei,BI Yong-min.The mechanical effect of herniated disk on the thecal sac in lumbar disk herniation and its clinical meanings[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(12):803~804
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