基于调筋理脊通络法治疗腰椎间盘突出症的应用研究

Correlation study of the changes of pelvic sagittal parameters and clinical efficacy in patients with lumbar spondylolisthesls

目的对调筋理脊通络法治疗腰椎间盘突出症的临床效果进行分析。方法选择2015-12-2016-06在本院治疗的腰椎间盘突出症患者120例,随机将其分为治疗组和对照组两组各60例,对照组患者采用推拿治疗,治疗组患者采用调筋理脊通络法治疗,比较两组患者的临床治疗效果以及治疗前后的VAS疼痛评分和JOA评分。结果与对照组相比,治疗组患者的治疗有效率显著提高,VAS疼痛评分显著降低,JOA评分显著提高,经比较差异均具有统计学意义(均P<0.05)。结论调筋理脊通络法应用于腰椎间盘突出症的治疗中疗效确切,且有助于减轻患者疼痛,预防复发,对于提高患者预后具有积极意义,建议在临床上推广应用。

Objective To study the correlation between the changes of pelvic sagittal parameters and clinical efficacy in patients with lumbar spondylolisthesis. Methods 75 patients with lumbar spondylolisthesis received lumbar fusion surgery from April 2012 to April 2015 were enrolled as the observation group, received transforaminal lumbar interbody fusion. 60 healthy volunteers received physical examination in our hospital during the same period were enrolled as control group. Lumbar lateral X-ray examination was performed and pelvic incidence angle （PI）, pelvic tilt（PT）, sacral inclination angle （SS）, lumbar lordosis angle （LL）, intervertebral height （DH） were determined. VAS table, JOA scale and ODI index were used to evaluate the degree of pain and dysfunction. Results PI, PT of observation group before surgery were higher than the control group, SS, LL and DH were lower than the control group, the differences between the two groups were statistically significant（P〈0.05 ）. 3 months after surgery, PI, PT and VAS, ODI scores of patients with lumbar spondylolisthesis were lower than those before surgery, SS, LL, DH and JOA score were higher than those before surgery, the differences between before and after surgery were statistically significant （P〈0.05）. PI, PT were positively correlated with VAS score, ODI index, negatively correlated with JOA score. SS, LL, DH were negatively correlated with VAS score, ODI index, positively correlated with JOA score. Conclusion Pelvic sagittal parameters PI, PT, SS, LL, DH are closely related to the improvement of pain degree and dysfunction degree before and after surgery.