单(多)个椎体位移致足下垂型腰椎间盘突出的临床研究  

Subluxation of single(multiple)vertebra and foot drop secondary to lumbar disc herniation

作　　者：冯伟 冯子鹤 王飞 杨文东 刘洪波 安建鹏 王雅蓉 FENG Wei;FENG Zihe;WANG Fei;YANG Wendong;LIU Hongbo;AN Jianpeng;WANG Yarong(Department of TCM Manipulative Orthopedic,Air Force Medical Center,Beijing 100142;Department of Orthopedics,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China;不详)

机构地区：[1]空军特色医学中心中西医结合正骨科,北京100142 [2]首都医科大学附属北京朝阳医院骨科,北京100020

出　　处：《空军航空医学》2023年第1期44-48,共5页AVIATION MEDICINE OF AIR FORCE

基　　金：军队后勤科研重点项目(BKJ17J006);空军军医大学课题(2019ZTA03)。

摘　　要：目的初步研究单(多)个椎体位移致足下垂型腰椎间盘突出症的机理、分析并总结该疾病临床表现特点及运用脊柱(定点)旋转复位法为主纠正椎体位移临床治愈该疾病要点。方法收集2018年10月—2022年4月在空军特色医学中心中西医结合正骨科收治的10例足下垂型腰椎间盘突出症患者的临床资料,对其一般情况、临床症状、辅助检查、治疗经过及疾病结局等方面进行回顾性分析。结果(1)纠正单(多)个椎体位移治疗10例足下垂型腰椎间盘突出症患者中8例临床治愈,2例临床改善。(2)所有患者腰椎核磁均呈现游离型椎间盘突出或脱出,其中6例髓核游离部分在远期随访复查核磁中表现为髓核吸收。(3)通过单因素重复测量方差分析,患者临床症状的恢复(VAS评分、ODI评分及肌力变化)与影像学髓核变化不同步且不平行。结论单(多)个椎体位移是足下垂型腰椎间盘突出症的主要病理改变,脊柱(定点)旋转复位法为主纠正椎体位移是治疗该疾病安全有效的保守治疗方法。Objective To study the correlations between subluxation of single(multiple)vertebrae and foot drop secondary to lumbar disc herniation,analyze the clinical features of this disease and identify effective treatments.Methods The clinical data of ten patients with foot drop secondary to lumbar disc herniation treated with Feng's spinal manipulation(FSM)in Air Force Special Medical Center between October 2018 and April 2022 was collected.The demographics,clinical symptoms,results of imaging examination,process of treatment and outcomes were retrospectively analyzed.Results①Among the ten patients with foot drop secondary to lumbar disc herniation treated with the reduction of vertebra subluxation,eight were clinically cured and two had their symptoms improved.②Lumbar MRI revealed sequestration-type lumbar disc herniation in all the ten patients.Shifted nucleus pulposis was found to be absorbed in six of these cases,as evidenced by MRI during the long-term follow-up.③Based on repeated one-way ANOVA,the clinical recovery of these patients was not synchronized and not parallel to radiographic changes.Conclusion The subluxation of the single(multiple)vertebrae is the main pathological cause of foot drop secondary to lumbar disc herniation.FSM is a safe,effective and conservative treatment for this disease.

关 键 词：椎体位移 腰椎间盘突出症 足下垂 

分 类 号：R68[医药卫生—骨科学]