仰卧前屈拔伸牵引治疗中老年根型颈椎病的疗效及机制初探  

Preliminary Study on the Effect and Mechanism of Supine-Flexion Traction on Middle-aged and Elderly Patients with Cervical Spondylotic Radiculopathy

作　　者：林定坤[1] 许鸿智[1] 侯宇[1] 苏国义[1] LIN Dingkun;XU Hongzhi;HOU Yu;SU Guoyi(Department of Orthopaediees, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510000,China.)

机构地区：[1]广东省中医院骨科,广州510000

出　　处：《中国中医骨伤科杂志》2018年第5期31-34,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：广东省中医药局科研项目(粤中医[2017]4号);广东省中医院中医药科学技术研究专项(YK2013B1N06)

摘　　要：目的:初步探讨仰卧前屈拔伸牵引治疗中老年根型颈椎病的疗效及机制。方法:共纳入60例中老年神经根型颈椎病患者,应用仰卧前屈拔伸牵引法进行保守治疗,并结合多体位磁共振(MRI)评价椎管矢状径的变化与疗效之间的关系。结果:60例患者全部完成多体位MRI检查和10d的治疗干预,58例患者得到随访,有效随访率96.7%.治疗2,4,6,8,10d及1年随访的VAS评分均较治疗前降低,差异有统计学意义(P<0.01),治疗10d及1年随访的NDI评分也明显低于治疗前,差异有统计学意义(P<0.01)。中立位、前屈位和后伸位的椎管有效矢状径分别为(8.48±1.71)mm,(9.09±2.19)mm和(7.79±2.04)mm,前屈位>中立位>后伸位。经Spearman相关性分析,前屈中立体位椎管有效矢状径的差值与治疗前后VAS评分差值、NDI评分差值之间,没有显著相关性。结论:仰卧前屈拔伸牵引法是治疗中老年根型颈椎病的有效疗法。前屈位可扩大中老年根型颈椎病患者的椎管有效矢状径,但椎管有效矢状径的变化与疗效的变化之间,并没有显著相关性。仰卧前屈拔伸牵引法治疗中老年根型颈椎病的具体作用机制,尚需进一步研究。Objective：To preliminary investigate the effect and mechanism of supine-flexion traction on middle-aged and elderly patients with cervical spondylotic radiculopathy.Methods：A total of 60 middle-aged and elderly patients with cervical spondylotic radiculopathy were treated by supine-flexion traction,and the relationship between the sagittal diameter of vertebral canal and the therapeutic effect was evaluated by multi position magnetic resonance imaging.Results：All the 60 patients completed the multi position MR examination and 10 days of treatment intervention.58 patients were followed up,and the effective follow-up rate was 96.7%.The VAS scores of 2 days,4 days,6 days,8 days and 1 year follow-up were lower than those before treatment（P〈0.01）,and the NDI score of 10 days and 1 year follow-up was lower than that before treatment（P〈0.01）.The effective sagittal diameters of the spinal canal were（8.48±1.71）mm,（9.09±2.19）mm,（7.79±2.04）mm in neutral,flexion and extension position：flexion〉neutral〉extension.Spearman correlation analysis showed that there was no significant correlation between the difference of the effective sagittal diameter of the spinal canal in the flexion and the difference of VAS score and NDI score before and after the treatment.Conclusion：Supine-flexion traction is an effective treatment for middle-aged and elderly patients with cervical spondylotic radiculopathy.The flexion position can enlarge the effective sagittal diameter of the spinal canal in the middle-aged and elderly patients with cervical spondylotic radiculopathy,but there is no significant correlation between the effective sagittal diameter of the vertebral canal and the change of the therapeutic effect.The mechanism of supine-flexion traction in the treatment of cervical spondylotic radiculopathy in middle-aged and elderly patients needs further study.

关 键 词：中老年神经根型颈椎病 仰卧前屈拔伸牵引 多体位磁共振 

分 类 号：R681.5[医药卫生—骨科学]