新医正骨疗法治疗腰曲反向型腰椎间盘突出症的临床研究  

Clinical study on lumbar disc herniation with reversed lumbar curve

作　　者：冯伟 王飞 许奎 FENG Wei;WANG Fei;XU Kui(Department of TCM Manipulative Orthopedics,Air Force Medical Center,Beijing 100142,China)

机构地区：[1]空军特色医学中心中西医结合正骨治疗科,北京100142

出　　处：《空军医学杂志》2020年第1期65-67,74,共4页Medical Journal of Air Force

基　　金：原空军总医院课题(kz2015031)。

摘　　要：目的总结腰曲反向型腰椎间盘突出症(以下简称腰曲反向型)临床表现特点,初步探讨临床对策。方法采用脊柱(定点)旋转复位法为主治疗腰曲反向型15例,其中男10例,女5例;年龄22~56岁,平均35岁。治疗前后分别摄裸脚站立位后前位、侧位体型像,测量患侧直腿抬高角度,测量MRI上椎间盘突出最大层面矢状径指数(saggital index,SI),矢状位突出间隙角度;冠状位腰椎cobb角。结果患者临床表现重,腰曲反向,多个椎体位移。治疗后直腿抬高角度增加(P<0.05),矢状位突出间隙角度增大(P<0.05),冠状位cobb角减小(P<0.05),SI值无明显变化(P>0.05)。结论腰曲反向型腰椎间盘突出症临床表现重,椎体位移形式复杂,纠正椎体位移、恢复腰曲前凸曲线是临床治愈的关键。Objective To sum up the clinical features of lumbar disc herniation with reversed lumbar curve(LDHRLC) and recommend a related strategy.Methods Fifteen patients(10 males and 5 females)with LDHRLC were treated with spinal?xed-point rotating reduction,whose age ranged from 22 to 56 with a mean age of 35 years old.Straight leg raising(SLR)was measured with software Adobe Photoshop in body pictures before and after treatment.The sagittal index(SI)of the protruded disc in the axial plane in MRI,the angle of involved intervertebral space in the sagittal plane of MRI,and the Cobb angle in the coronal plane in MRI were all measured before and after treatment.Results Patients with LDHRLC showed severe clinical manifestations,reversed lumbar curves and multi-vertebrae displacement.SLR increased signi?cantly after treatment(P<0.05).The angle of involved intervertebral space in the sagittal plane of MRI increased after treatment(P<0.05).The Cobb angle in the coronal plane decreased after treatment(P<0.05).There was no signi?cant difference in SI before or after treatment(P>0.05).Conclusion Patients with LDHRLC show severe clinical manifestations and complex patterns of vertebral displacement.The key to clinical cure is to correct vertebral displacement and restore the lumbar curve.

关 键 词：腰椎间盘突出症 腰曲反向 椎体位移 脊柱(定点)旋转复位法 

分 类 号：R681.5[医药卫生—骨科学]