腰椎间盘突出后自然吸收及其相关因素的研究

Research on Internal Absorption and Related Factors After Protrasion of Intervertebral Disc in Lumbar

目的:通过对50例腰椎间盘突出症患者治疗前后的临床资料分析,探讨牵引、手法、针灸等非手术疗法对突出的腰椎间盘自然吸收现象的影响。方法:根据影像学分型将突出后的椎间盘分为突出型、脱出型、游离型,将椎管的形态分为椭圆型、三角型、三叶型。通过椎管横径、矢状径与突出物截面积之比值来观察和分析突出物的变化,所得数据经统计学处理。结果:本研究认为患者椎管的截面积越大自然吸收的机率就越大,椭圆型椎管最好,三角型椎管次之,三叶型椎管最差。根据椎间盘突出的分型,发现纤维环破裂后髓核游离的越远,自然吸收的可能就越大。急性发病,临床症状、体征越重,经本法治疗后临床效果越好,自然吸收的可能就越大,尤其是急性发作的游离型,因突入硬膜囊外的髓核成份多,更易通过排异反应而吸收。结论:牵引和手法等非手术疗法可促进腰椎间盘突出后的自然吸收。

Objective:By analyzing the medical records on 50 patients with protrasion of intervertebral disc in lumbar, we studied the effects on internal absorption by the treatment of dragging, manipulation, acupuncture and non -operation, etc. Methods:The extend is typed into three types protruding, falling out and freedom according to iconography. The shape of vertebral canal is typed into three types;ellipse, triangle and three - leaf. We have observed and analysed the changes by value of diameters of vertebral canal and vector, and the cross area of the extend. The data has been treated statistically. Results:The study shows that the larger of the cross area on the vertebral canal, the stronger ability of the absorption; while the best absorption is the type of ellipse, the better, triangle, and the worst, three - leaf. The farther the nucleus pulposus, the stronger ability of the absorption, Based on the typing, after the anulus firbrosus is destroyed, the farther the nucleus pulposus frees, the better the internal absorption. The more clear the clinical symptom and sign, the better the clinical effects by dragging , manipulation and physical therapy and the better the internal absorption, especially the type of freedom in acute attack, for the more component of nucleus pulposus protruded outside of the durae matris and easily was absorbed with the rejection. Conclusions: Promote the absorption of protrasion of intervertebral disci in lumbar by dragging, manipulation and physical theropy, etc.