手法治疗腰椎间盘突出症术后复发的临床研究

A Clinical Study of Manual Therapy for Post-operation Recrudescence of Lumbar Intervertebral Disc Protrusion

目的：通过对腰椎间盘突出症术后复发机理和手法治疗本病症机理的探究,寻找治疗腰椎间盘突出症术后复发病症的方法.方法：运用三步三位手法,辅助配合内服中药、针刺治疗.结果：本组56例,总有效率81%;得到随访的34例中总有效率81%.结论：腰椎间盘突出症术后复发的主要原因是原间隙或者上下间隙椎间盘再突出,其次是术后继发的硬脊膜粘连或者非手术间隙黄韧带增厚,再次是椎体和小关节的退行性改变等;正确运用手法,辅助配合内服中药、针刺治疗是治疗本病症的重要方法之一.

Objective：This thesis explores the working mechanism of the recrudescence following a surgical operation of the lumbar intervertebral disc protrusion （LIDP） and its manual therapy, in an effort to find a effective method to treat the post--operation recrudescence of LIDP. Methods： The treating method is a three--step--three--position manipulation, assisted with Chinese traditional medicine and acupuncture. Result：The general efficacy rate is 81~ in a sample of 56 cases under study. In a random interview of 34 cases, the general efficacy rate is also 81~. Conelusion： The major cause of the post--operation recrudescence of LIDP is the protrusion of intervertebral disc reoccurring in the original space or in the space be- tween the above and lower vertebrae, the secondary cause is the epidural conglutination following the operation or the increment of the yellow ligament in the non-operation space, and the minor cause is the degenerative changes due to vertebrae and facet joints. Therefore, one of the crucial treatment methods for the recrudescent complications is the correct use of the manipulative therapy, assisted with Chinese traditional medicine and acupuncture.