杠杆定位手法对正常腰椎影响的生物力学实时测试  

Real-time Biomechanical Test of Effect of Leverage Positioning Manipulation on Normal Lumbar Vertebra

作　　者：吕立江[1] 陆森伟[1] 王晓东[1] 朱朝阳[2] 范炳华[1] 应晓明[1] 应航[1] 杨国平[1] 

机构地区：[1]浙江中医药大学第三临床医学院,浙江杭州310053 [2]浙江大学医学院浙江省生物电磁学重点实验室,浙江杭州310058

出　　处：《中华中医药学刊》2015年第1期15-17,I0002,I0003,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81273866);国家临床重点专科建设项目(国医卫发2013-42号);浙江省自然科学基金项目(Y2111054);浙江省科技厅公益技术项目(2012C33067)

摘　　要：目的：探讨杠杆定位手法对腰椎间盘的作用机理,为手法的临床推广应用提供实验学依据。方法：应用模拟杠杆定位手法建立生物力学建模,用CT对健康志愿者的腰椎4~5进行实时扫描,观察3种体位下的腰椎生理曲度、腰椎间盘与神经根的距离与腰椎管前后径的变化。结果：平躺位、后伸位、加力后伸位分别实时测试取腰椎4~5最中间层数据比较,发现后伸加力位的腰椎生理曲度、腰椎间盘与神经根的距离与腰椎管前后径的距离均变大。结论：杠杆定位手法可使腰椎生理曲度发生变化,即腰椎在原有基础上曲度加大,增加了腰椎脊柱的稳定性,同时使椎间盘与神经根发生位移和腰椎管前后径的距离变大,初步明确了杠杆定位手法治疗腰椎间盘突出症的治疗机理。Objective： To investigate the mechanism of lever positioning manipulation on lumbar disc and to provideexperimental evidence for clinical application practices. Method： The biomechanics model was established by means ofsimulation manipulation. The real - time CT scanning was used for the L, -5 spine of healthy volunteers and lumbar lordo-sis, distance between lumbar disc and nerve root diameter, anteroposterior diameter of the spinal canal under three posi-tions were observed. Results： Comparing real -time test data of the intermediate layer L,_5 under three position, it showedthat lumbar lordosis, distance between lumbar disc and nerve root diameter, anteroposterior diameter of the spinal canalwere increasing during extension. Conclutions ： Lever positioning manipulation allows lumbar lordosis changes and increa-ses the stability of the lumbar spine. Meanwhile, distance between lumbar disc and nerve root diameter, anteroposterior di-ameter of the spinal canal are increasing, which is the mechanism for lever positioning manipulation treatment of lumbardisc herniation.

关 键 词：杠杆定位手法 腰椎间盘 生物力学 人体 

分 类 号：R681.53[医药卫生—骨科学]