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借助3D-MRI扫描探讨脊柱(定点)旋转复位法治疗腰椎间盘突出症的临床研究
Hits: 2027   Download times: 1413   Received:February 25, 2013    
作者Author单位UnitE-Mail
冯伟 FENG Wei 空军总医院中西医结合正骨治疗科, 北京 100142 Department of TCM Manipulative Orthopaedic, General Hospital of Airforce, Beijing 100142, China 13910240820@139.com 
冯天有 FENG Tian-you 空军总医院中西医结合正骨治疗科, 北京 100142 Department of TCM Manipulative Orthopaedic, General Hospital of Airforce, Beijing 100142, China  
毕永民 BI Yong-min 空军总医院医学影像科, 北京 100142  
王飞 WANG Fei 空军总医院中西医结合正骨治疗科, 北京 100142 Department of TCM Manipulative Orthopaedic, General Hospital of Airforce, Beijing 100142, China  
许奎 XU Kui 空军总医院中西医结合正骨治疗科, 北京 100142 Department of TCM Manipulative Orthopaedic, General Hospital of Airforce, Beijing 100142, China  
王淑琴 WANG Shu-qin 空军总医院中西医结合正骨治疗科, 北京 100142 Department of TCM Manipulative Orthopaedic, General Hospital of Airforce, Beijing 100142, China  
期刊信息:《中国骨伤》2013年26卷,第6期,第476-480页
DOI:10.3969/j.issn.1003-0034.2013.06.009


目的: 观察脊柱(定点)旋转复位法治疗腰椎间盘突出症前后突出髓核与神经根的三维空间位置变化,探索该手法治疗腰椎间盘突出症的机制。

方法: 2009年4月至2011年6月采用脊柱(定点)旋转复位法治疗L5S1腰椎间盘突出症52例,男33例,女19例;年龄19~55岁,平均34.6岁。治疗前后均进行3D-MRI扫描,观察突出髓核与受累神经根解剖关系及核磁冠状位脊柱-骨盆构形变化。

结果: MRI显示患者突出髓核与受累神经根解剖关系分为腋侧、肩侧、前方、包围4种类型。手法治疗后触诊患椎椎体位移消失,腰腿痛锐减。所有患者获随访,时间2~28个月,平均12个月,疾病未复发,所有患者恢复原工作或学习。3D-MRI轴位与入院时对照所有病例突出髓核大小形态无显着变化,患者腰椎-骨盆的曲线均有改变。

结论: 腰椎间盘突出症存在单(多)个椎体位移。椎体位移致腰椎-骨盆构形改变造成髓核及受累神经根生物力学特性的改变,脊柱(定点)旋转复位法纠正患椎椎体位移,恢复了脊柱内外因素平衡,从而达到治疗目的。
[关键词]:手法治疗  椎间盘移位  腰椎  脊柱  磁共振成像
 
Spinal fixed-point rotating reduction in treating lumbar disc herniation by three-dimensional MRI
Abstract:

Objective: To observe three-dimensional space position change of nucleus pulposus and nerve root before and after treatment of lumbar disc herniation by spinal fixed -point rotating reduction,and explore the mechanisms.

Methods: Totally 52 patients with L5S1 lumbar disc hernation treated by spinal fixed-point rotating reduction were collected from April 2009 to June 2011. There were 33 males and 19 females with an average age of 34.6 years old(ranged,19 to 55). Three-dimensional MRI were performed to observe relationship between nucleus pulposus and related nerve root,configuration change of spine and pelvic on coronary MRI.

Results: MRI showed relationship between nucleus pulposus and related nerve root mainly located on axillary,shoulder,front and surround. Vertebral displacement disappeared,lumbocrural pain alleviated after manipulative therapy. All patients were followed up from 2 to 28 months with an average of 12 months,and no recurred. All patients recovered work. Nucleus pulposus had no change,while lumbral spinal and pelvic curve changed before and after admission.

Conclusion: Lumbar disc herniation combined with single(multiple) vertebral displacement,can cause biomechanical properties of nucleus puplosus and related nerve root,while spinal fixed-point rotating reduction can correct vertebral displacement,recover balance between inside and outside of spinal.
KEYWORDS:Manipulation therapy  Intervertebral disk displacement  Lumbar vertebrae  Spine  Magnetic resonance imaging
 
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,毕永民,王飞,许奎,王淑琴.借助3D-MRI扫描探讨脊柱(定点)旋转复位法治疗腰椎间盘突出症的临床研究[J].中国骨伤,2013,26(6):476~480
英文格式:FENG Wei,FENG Tian-you,BI Yong-min,WANG Fei,XU Kui,WANG Shu-qin.Spinal fixed-point rotating reduction in treating lumbar disc herniation by three-dimensional MRI[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(6):476~480
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