腰椎术后骶髂关节源性下腰痛的特点和治疗  

Analysis of clinical character and management for the sacroiliac joint pain after lumber fusion

作　　者：陈剑峰[1] 汤建华[1] 田小武[1] 

机构地区：[1]南京中医药大学无锡附属医院脊柱脊髓科,江苏无锡214001

出　　处：《实用临床医药杂志》2011年第5期39-41,48,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨腰椎术后骶髂关节源性下腰痛的特点和治疗。方法2006～2009年对64例腰椎术后骶髂关节源性下腰痛的患者进行回顾性研究。综合分析临床资料、体征及影像学表现，总结其临床特点，并予手法调整骶髂关节，辅予封闭术治疗，通过VAS、活动能力及改良Macnab标准来评定治疗疗效。结果随访8～42个月（平均22．7个月），患者治疗后的VAS评分（2．01±1．03）较治疗前（901±2．30）改善明显（P〈0．01）；活动能力评分（1．叭±03）较治疗前（2．6±0．30）改善明显（P〈0.01）。结论腰椎融合术后骶髂关节病变是引起术后下腰痛的重要原因之一，腰椎术后应力的改变导致的骶髂关节错位是骶髂关节源性下腰痛的主要原因。封闭是诊断骶髂关节源性下腰痛的最有效的方法，手法调整骶髂关节，辅予封闭术治疗该疾病的简单、安全、有效的方法。Objective To investigate the clinical character and the management of sacroiliac joint pain after lumber fusion. Methods 64 patients with sacroiliac joint pain after lumbar fusion between 2006 and 2009 were analyzed retrospectively about clinical data, physical sign and image. We use bone setting manipulation and sacroiliac anesthetic blocks to treat of sacroiliac joint dislocation. The visual analogue scale （VAS）, mobility, and modified MacNab criteria were employed to measure the clinical outcomes. Results The time of followup was from 8 months to 42 months （average time was 22.7 months）. The results show that all the patients back pain relieved immediately after treatment and their VAS was distinctly decreased from （9.01 ±2.30） preoperation to （2.01 ±1.03） postoperation with significant difference （P 〈 0.01）; scale of patient mobility was respectively decreased from （2.6 ±0.30） preoperation to （ 1.01 ±0.3） postoperation with significant difference （P 〈 0.01 ）. Conclusion Sacroiliac joint pain after lumbar fusion is an important cause for recurrence of low back pain. The stress change in the sacroiliac joint after lumber fusion and degeneration are a factor of subluxation of sacroiliac joint. Sacroiliac anesthetic blocks to determine this frequency is a good technique. Treatment of sacroiliac joint dislocation with bone setting manipulation and sacroiliac joint dislocation is an ideal technique for the treatment of sacroiliac joint pain after lumber fusion to have strong purpose and will guarantee good clinical outcome.

关 键 词：骶髂关节 腰痛 手法治疗 封闭治疗 

分 类 号：R681.5[医药卫生—骨科学]