中立位无症状运动治疗颈椎病357例随访分析  

No-symptom motion around neutral position for cervical spondylosis: A follow-up analysis in 357 cases

作　　者：王万明[1] 庄颜峰[1] 李杰[1] 张志宏[1] 孙梁[1] 陈庆泉[1] 

机构地区：[1]福州总医院骨科,福建省福州市350025

出　　处：《中国组织工程研究与临床康复》2007年第52期10477-10479,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：中央保健局保健专项资金资助科研课题(D002)~~

摘　　要：目的:颈椎间盘的退变是一种持续存在的自然过程,在分析颈椎生物力学特点的基础上观察"中立位无症状运动"治疗颈椎病的临床效果。方法:选择2000-01/2005-09在福州总医院骨科门诊就诊的颈椎病患者357例,均知情同意。在急性期治疗后对颈椎病患者施行"中立位无症状运动",即患者颈部处于某一位置时没有颈椎四肢酸痛麻木等症状,此为中立位,以此为基准,主动限制各方向的活动范围,一般来说屈伸在45°范围内,旋转不超过30°,各方向活动轻柔和缓,避免较长时间处于某一位置。间歇性进行控制下颈部肌肉的等长收缩活动,以此促进组织的血液循环和调节椎间盘内应力负荷,按照体操节律进行,4次/d,持续4周。治疗后定期通过门诊复诊和电话随访。疗效评估标准:①优:症状、体征基本消失,随访期间1年内无复发。②良:症状、体征大部分消失,或消失后半年内复发1次,经治疗恢复。结果:357例患者全部进入结果分析。357例患者随访12～60个月,其中12～24个月74例,25～36个月96例,37～48个月102例,49～60个月85例,平均38个月。①疗效优良率为89.07%。②对比观察87例患者治疗前后X射线片无明显变化;对比观察32例患者治疗前后MRI图片,其中29例无明显变化,3例椎间盘突出程度加重,症状加重,予以手术治疗,恢复良好。结论:"中立位无症状运动"对颈椎病患者具有良好的治疗作用,随访的部分X射线片及MRI显示,椎间盘的退变没有恢复,但也没有明显加重。AIM：Degeneration of cervical intervertebral disk is a persistent existing natural process. This study was designed to analyze the clinical effect of ＂no-symptom around neutral position＂ on the cervical spondylosis. METHODS： Totally 357 cervical spondylosis patients, who were examined in Out-patient Clinic, Department of Orthopaedics, Fuzhou General Hospital from January 2000 to September 2005. They all knew the facts and agreed to participate in the trial. After acute stage treatment, ＂no-symptom motion around neutral position＂ was treated, namely neutral position on which the head was maintained without the presence of pain and/or numbness on neck and extremities. The motion at all directions was limited actively around the neutral position. Generally speaking, the range of motion for neck extension and flexion was within 45° and less than 30° for neck rotation. The motion was conducted softly and smoothly. It was avoided that the neck should be maintained at one position for a long time. Intermittent isometric contraction of cervical muscle was employed to improve blood circulation in the soft tissue of cervical spine and regulate the intradiscal stress on the basis of gymnastics rhythm, four times a day, for successively 4 weeks. The following clinical manifestations were recorded in follow-up through clinical examination and telephone requiring. Evaluation criteria of curative effect： （1）excellent： symptom and physical sign disappeared basically, no relapse within 1 year, （2）good： symptom and physical sign disappeared mostly, or one relapse within half a year, and recovered after treatment. RESULTS： Totally 357 patients were involved in the result analysis. Follow-up was performed from 12-60 months in 357 patients, of which 12-24 months in 74 cases, 25-36 months in 96 cases, 37-48 months in 102 cases, 49-60 months in 85 cases, averagely 38 months. （1）The excellent and good rate was 89.07%. （2）X-ray film analysis of 87 cases showed that there was no significant change in t

关 键 词：颈椎病 运动 制动 

分 类 号：R681.531[医药卫生—骨科学]