神经根型颈椎病推拿治疗的MSCT评价  

MSCT Evaluation of Cervical Spondylotic Radiculopathy under Tuina Therapy

作　　者：詹松华[1] 赵喜[1] 谭文莉[1] 杨烁慧[1] 张敏[1] 李欢欢[1] 龚志刚[1] 詹红生[1] 

机构地区：[1]上海中医药大学附属曙光医院放射科上海市普安路185号,上海200021

出　　处：《中国医学计算机成像杂志》2012年第1期42-46,共5页Chinese Computed Medical Imaging

基　　金：国家重点基础研究发展计划(973)项目(项目编号:2007CB512701)~~

摘　　要：目的:探讨神经根型颈椎病进行推拿治疗后的疗效及其MSCT扫描三维重建显示的价值。方法:临床确诊神经根型颈椎病患者30例纳入研究,男11例,女19例,平均年龄(50.97±12.43)岁(27～67岁)。在实施推拿手法治疗前后分别完成颈椎MSCT检查,记录临床症状、体征及VAS疼痛评分。采用16或64层MSCT,层厚0.625～1mm,完成MPR和VR重建,观察颈椎曲度、寰枢关节关系、棘突与中线的关系、椎体前后径线和左右径线与中轴线角度、各椎体水平方向旋转角度、椎间孔和椎间盘。结果:治疗后患者临床症状及体征明显好转,VAS评分从9.30±0.65分降至1.10±0.89分。MSCT显示治疗后颈椎弧度平均为(5.08±3.61)mm,较治疗前的(1.91±4.99mm)明显增大(t=-4.27;P=0.000);治疗后椎间孔狭窄数量明显减少(80/230下降为35/320);治疗后两侧寰齿关节不等距的数量从15例减至2例;治疗后棘突-中线距离为(0.87±1.70)mm,明显小于治疗前的(2.11±1.68)mm(t=7.53;P=0.000);治疗后椎间盘突出/膨出数为42个,较治疗前的63个明显减少。结论:MSCT扫描和重建可以有效评价神经根型颈椎病治疗效果,推拿可以改善颈椎生理曲度、椎间孔大小及椎间小关节位置关系。Purpose：To analyze the clinical efficacy of tuina therapy for the cervical spondylotic radicu- lopathy by multi - slice spiral CT imaging. Methods： Image data of thirty patients with cervical spondy- lotic radiculopathy were collected. All patients were performed cervical multi - slice spiral CT study be- fore and after the tuina therapy. All clinical symptoms, signs and VAS scores were recorded. The changes of cervical morphology in both MSCT studies were observed, including cervical curvature, atlantoaxial joint, the relationship of the spinous process and the midline of vertebral body position, intervertebral foramen and intervertebral disc. Results： After tuina treatment, all patients had a significant improve- ment in the clinical symptoms and signs. VAS score decreased by （8.20 ± 0.92） points. The average val- ues of cervical curvature before and after treatment were （1.91± 4.99） mm and （5.08 ± 3.61） mm, there was a significant difference between them（P = 0. 000; t = - 4.27） . There were 80 narrow intervertebral foramens before treatment, the number was 35 after tuina therapy. The number of odontoid skews before and after treatment were 15 and 2. The distances from the spinous to centerline before and after treat- ment were （2.11 ± 1.68） mm and （0.87 ± 1.70） mm （P = 0. 000; t = 7.53）. The number of intervertebral disk hernia and slipped disc were 63 and 42 before and after tuina therapy, respectively. Conclusions： Tulna therapy is effective for cervical spondylotic radiculopathy by improving the cervical curvature, foraminal size and the relationship of facet joint position. Multi - slice CT imaging has an important ref- erential value in the evaluation of clinical efficacy of tuina therapy in cervical spondylotic radiculopathy.

关 键 词：神经根型颈椎病 MSCT 推拿 

分 类 号：R274.9[医药卫生—中西医结合] R816.8[医药卫生—中医骨伤科学]