旋转复位法对单侧型L_5/S_1椎间盘突出症的影响

The Influence of Revolving Reposition for Unilateral L_5/S_1 Disc Herniation

目的:探讨旋转复位手法治疗腰椎间盘突出症的疗效及疗效与影像学区域定位分布的相关性,为腰突症疗效提高评估寻求新的理论依据。方法:将60例符合纳入标准的腰椎间盘突出症患者,随机分组,其中治疗组30例,采用腰椎旋转复位手法治疗;对照组30例,采用仰卧位骨盆牵引法治疗。观察临床疗效,并对治疗前后临床指标与影像学区域定位相关性做出评价。结果:临床观察表明,治疗组总有效率为87%,对照组总有效率为63%,治疗组疗效优于对照组。在影像学方面,对突出物区域定位分布与疗效的相关性进行分析,P<0.05,差异有统计学意义。结论:临床研究表明:1.旋转复位手法治疗腰椎间盘突出症安全、有效;2.在症状与体征改善方面,旋转复位手法治疗腰椎间盘突出症优于牵引治疗;3.患者疗效与突出物区域定位分布相关,分布在"I层1-2/2区a-b域"的病人通过手法治疗,可以取得良好疗效。

Objective To investigate the clinical efficacy of revolving reposition in the treatment of lumbar disc herniation and the correlation between clinical efficacy and imaging orientation, and to improve the assessment method in order to seek a new theoretical basis for a better efficacy of lumbar disc herniation. Methods ~ According to random number table, 60 cases of lumbar disc herniation who were in accordance with the inclusion criteria were randomly divided into trial group and control group, 30 cases in each group. The clinical effect was observed and the correlation between clinical efficacy and imaging orientation was evaluated. Results Clinical observation showed that the total effective rate of the trial group was 87%, while the control group was 63 %. The correlation between clinical efficacy and imaging orientation which was processed by statis- tics showed significant difference（P〈0.05）. Conclusion.. 1Rotating spinal manipulation is a safe and effective method for the treatment of lumbar disc herniation. 2 As for the improvement in symptoms and signs, the rotatory reduction manipulation for lumbar disc herniation is superior to traction therapy. 3 The clinical efficacy was correlated with imaging orientation. The discs located in Area a and b, Zones i and 2,Level I showed the best curative effect.