腰椎手法关节和椎间盘压力的力学研究

The mechanics research of lumbar joints and intervertebral disc pressure in manipilation

目的通过压力测量对新鲜脊柱标本进行生物力学实验,测量不同手法对椎间盘和关节的应力变化。方法本实验采用新鲜中年男性尸体,制作脊柱及骨盆标本(保存肌肉韧带),在不同力学状态下(脊柱关节冲击手法、关节松动手法和脊柱单纯旋转),应用压力测量技术获得腰椎L_1-L_5关节突内及椎间盘压力数据。结果实验发现松动手法主要作用点为腰椎关节,对椎间盘影响小。冲击手法对于腰椎关节、椎间盘压力影响较大,在扭力中心有明显的扭力集中现象。结论关节手法对腰椎关节产生明显的压力影响,冲击手法尤甚。如何把握这种压力影响,可能是发挥手法效应和控制副损伤的关键,这为进一步解释手法风险和副作用产生的机理,提供了良好的证据。

Objective To measure the pressure of intervertebral disc and the post joints through fresh specimens of spinal biomechanical experiments. Methods The research make the spine and pelvis specimens （conclude the muscle and ligament）from fresh middle-aged male body. The research measured the pressure of intervertebral disc and the post joints in the different condition of mechanical tactics （spinal thrusting manipulation, mobilization and spinal pure rotation）. Results The experiment found the pressure of the post joint was higher than in the disc in the mobilization. But the pressure of the post joint and disc in the thrusting manipulation was higher than the pressure with mobilization. There was obvious torsion concentration in the center of the torque. Conclusion The spinal joint manipulation has obvious stress effects in the lumbar posterior joint, especially in the thrusting manipulation. How to control the stress may be the key to play therapy effect and control side effect. This study provides good evidence of the mechanism of the risks and side effects in manipulation.