手法复位在腰椎骨折治疗中的实验观察

Experimental Observation of Maneuver Naprapathy Reduction in Treatment of Thoracolumbar Fracture

目的 :胸腰椎骨折治疗的主要目的是恢复椎体高度 ,体位复位与手法复位是临床常用的方法。由于椎体、韧带、椎间盘在复位中是多因素相互作用的动态组合结构 ,本研究重点在实验条件下分析两种复位对伤椎椎前高恢复的机制和差异。方法 :采用湿润脊柱标本 ( T11～L3) ,运用改良 Gepstein方法制造 L1压缩骨折模型。标本分组分别在过伸复位、纵向牵引过程中比较手法复位的作用结果 ,分析不同复位后椎前高变化、前纵韧带应变变化、伤椎上下椎间盘高变化的关系。结果 :不同复位过程都存在椎前高恢复平台期 ,复位后期都明显受脊柱解剖结构制约。手法复位参与的复位效果出现早 ,未参与的复位效果出现晚。结论 :通过本研究可见复位效果都不是无限制的 ,合理运用手法复位是非常有益的。

Objective:To investigate the mechanism and difference between body posture reduction and maneuver naprapathy reduction in treatment of thoracolumbar fracture.Methods:20 wet spinal specimens (T 12 ～L 3) were employed to make the L 1 fracture models (by reformed Gepstein method).The maneuver naprapathy reduction process.Detailed parameters include:forevertebral body height (FVBH) changes,anterior longitudinal ligament stress changes and vertebral disc height changes dierctly up and down the fractured vertebral body.Results:The FVBH recovering plateau existed in different reduction process and it was constricted by spinal structure at the late phase of reduction.The reduction result happened earlier if there is maneuver naprapathy.Conclusion:The reduction result is not unlimited during the above reductions.And the maneuver naprapathy is helpful in the reduction of thoracolumbar fracture.