三向旋角程控调整腰椎生理曲度的力学效应:随机对照分析

Mechanics effect of lumbar physiological curvature adjustment by three-dimensional swirl angle program control:A randomized controlled analysis

目的:探讨成角牵引配合纵向旋转调整腰椎生理曲度,恢复脊柱平衡对治疗椎间盘突出的临床意义。方法:①对象:选择2005-10/2006-01解放军第四五一医院行CT明确诊断符合观察标准的腰椎间盘突出患者71例。材料:三向旋角程控整复床,床面结构分为胸部固定旋转段、腰曲按摩磁热段、臀部牵引成角段;牵引力设定20～90kg。②分组:随机分为试验组(38例)和对照组(33例)。③干预措施:两组均采用仰卧屈膝牵引治疗20min后配合纵向旋转继续10min;试验组则以腰部以下床面成角20°实施,对照组采用平面牵引配合纵向旋转治疗。④采用日本整形学会腰椎疾患治疗成绩评分表进行腰椎功能疗效评价;观察改善指数及治疗次数。结果:71例患者全部进入结果分析。试验组和对照组治疗前腰椎功能评分差异无显著性意义(13.684±1.662,13.485±3.001,P<0.05),治疗后试验组评分高于对照组(24.632±1.777,18.667±2.533,P<0.01),试验组腰功能改善指数比对照组差异有显著性意义(0.443±0.007,0.281±0.119,P<0.01)。结论:成角牵引配合纵向旋转对椎间盘突出康复治疗及功能恢复有较好的效果。

AIM： To explore the regulation of lumbar physiological curvature by angulation traction and longitudinal rotation and the clinical significance of repairing spinal balance on lumbar disc herniation （LDH）. METHODS： （1）Totally 71 patients with LDH diagnosed by CT at the 451 Hospital of Chinese PLA were enrolled from October 2005 to January 2006. Three-dimensional swirl angle program control restitution bed was applied. This bed was composed of fixing chest swirl section, magnetic heat lumbar flexure massage section and traction haunch angulation section with the pull strength of 20-90 kg. （2）Tbe patients were divided into experimental group （n =38） and control group （n =33）. （3）All patients of the two groups received supine genuflex traction for 20 minutes and combined with longitudinal rotation for 10 minutes. Patients in the experimental group received 20° traction from below lumbar to bed, while patients in the control group received plane traction combined with longitudinal rotation. （4）Lumbar function was determined by eritcrion of the lumbar disease made by Japanese Shaping Association to observe improved indexes and times of treatment. RESULTS： Totally 71 patients were involved in the result analysis. No significant difference was found in preoperative lumbar function between experimental group and control group （13.684±1.662, 13.485±3.001, P 〈 0.05）. The score was higher in the experimental group than the control group after operation （24.632± 1.777, 18.667±2.533, P 〈 0.01 ） . Improved index of lumbar function showed significant difference in the experimental group as compared with the control group （ 0.443± 0.007,0.281±0.119, P〈 0.01） . CONCLUSION： Rehabilitative treatment and functional recovery aider LDH have good effects by angulation traction and longitudinal rotation.