非手术脊柱减压系统与常规牵引器治疗腰椎间盘突出症:表面肌电图分析的比较

Non-surgical spinal decompression system versus conventional traction device for treating lumbar disc herniation through surface electromyography

背景:非手术脊柱减压系统可针对腰椎间盘突出症的病变椎间盘进行治疗,牵引过程中避免椎旁肌收缩抵抗,目前缺乏结合表面肌电图分析非手术脊柱减压系统治疗腰椎间盘突出症疗效的研究。目的:对比常规腰椎牵引器,结合表面肌电图评价指标,探讨非手术脊柱减压系统DRX9000治疗腰椎间盘突出症的疗效。方法:选取腰椎间盘突出症患者60例,随机分为DRX9000组和普通牵引组,每组各30例。DRX9000组患者采用非手术脊柱减压系统DRX9000进行牵引治疗,普通牵引组患者采用常规牵引器进行牵引。所有患者在全部治疗前后进行腰部竖脊肌和多裂肌表面肌电图检查,对患者腰部椎旁肌肌力及疲劳程度进行评价,并采用目测类比评分法及日本骨科协会评估治疗分数(JOA评分)对患者疼痛程度及腰突症导致的功能障碍程度进行评定。结果与结论:(1)全部治疗结束后,2组患者患侧竖脊肌和多裂肌平均振幅及平均频率斜率均较治疗前升高(P<0.05),且DRX9000组显著高于普通牵引组(P<0.05);(2)全部治疗结束后,2组患者目测类比评分较治疗前降低,JOA评分较治疗前增加(P<0.05),DRX9000组目测类比评分显著低于普通牵引组,JOA评分显著高于普通牵引组(P<0.05);(3)结果提示,非手术脊柱减压治疗可有效改善腰椎间盘突出症患者椎旁肌肉活动力、肌力,减轻肌肉疲劳,减轻患者疼痛,改善功能,效果显著优于普通牵引。

BACKGROUND:Non-surgical spinal decompression system can be used for the treatment of diseased intervertebral discs and avoid contraction and resistance of paravertebral muscle during traction.At present,there is lack of analysis of the efficacy of non-surgical spinal decompression in the treatment of lumbar disc herniation through surface electromyography.OBJECTIVE:To compare the effect of non-surgical spinal decompression system DRX9000 with conventional traction device in the treatment of lumbar disc herniation through surface electromyography.METHODS:Totally 60 patients with lumbar disc herniation were randomly divided into DRX9000 group and general traction group,with 30 cases in each group.The patients in DRX9000 group were treated with non-surgical spinal decompression system DRX9000 and the patients in general traction group were treated with conventional tractor.All patients underwent surface electromyography examination of erector spinal muscle and multifidus muscle before and after all treatment to evaluate the strength and fatigue of paravertebral muscle.The Visual Analogue Scale and Japanese Orthopaedic Association scores were used to assess the degree of pain and impairment due to lumbar disc herniation.RESULTS AND CONCLUSION:(1)After all of the treatment,the average electromyogram and mean power frequency slope of affected erector spinal muscle and multifidus muscle in both groups were increased than those before treatment(P<0.05).The data of DRX9000 group were significantly higher than that of the general traction group(P<0.05).(2)After all the treatment,the Visual Analogue Scale score decreased and the Japanese Orthopaedic Association score increased in both groups at the end of treatment compared with before treatment(P<0.05).The Visual Analogue Scale score of DRX9000 group was significantly lower than that of the general traction group(P<0.05)and the Japanese Orthopaedic Association score of DRX9000 group was significantly higher than that of the general traction group(P<0.05).(3)These results showed that non-surgical spinal decompression system could effectively improve paravertebral muscle activity and muscle strength,lessen muscle fatigue,relieve pain,and improve function in patients with lumbar disc herniation,and its effect is obviously better than that of general traction.