基于杠杆定位手法对青少年特发性脊柱侧弯患者的脊柱-骨盆矢状位参数变化的研究

Research on the changes of sagittal parameters of spine and pelvis in patients with adolescent idiopathic scoliosis based on lever positioning manipulation

目的探讨杠杆定位技术对青少年特发性脊柱侧弯(AIS)患者脊柱-骨盆矢状位参数变化的影响。方法选取2016年10月至2020年10月在浙江中医药大学附属第三医院推拿科就诊的少年特发性脊柱侧弯患者60例,按随机数字表法分为观察组(n=30)和对照组(n=30)。对照组采用常规推拿正骨手法,观察组在常规推拿正骨基础上采取杠杆定位技术。在治疗前和治疗8周后对胸椎后凸角(TK)、腰椎前凸角(LL)、骨盆入射角(PI)、骨盆倾斜角(PT)、骶骨倾斜角(SS)、T1骨盆入射角(TPA)和脊柱矢状轴(SVA)数据进行统计分析,评估脊柱-骨盆矢状位的参数变化。结果两组治疗前TK、LL、PI、PT、SS、TPA、SVA比较,差异无统计学意义(P>0.05)。两组治疗后TK、LL、PI、PT、SS、TPA、SVA与治疗前比较,差异有统计学意义(P<0.05)。治疗后观察组TK、LL、PI、TPA与对照组比较,差异有统计学意义(P<0.05);观察组PT、SS、SVA与对照组比较,差异无统计学意义(P>0.05)。结论杠杆定位可有效恢复骨盆参数,改变AIS患者骨盆前倾位状态,从而恢复胸腰椎曲度,达到脊柱-骨盆矢状面躯干平衡。

Objective To investigate the impacts on the changes of sagittal parameters of spine and pelvis in patients with adolescent idiopathic scoliosis(AIS)based on lever positioning manipulation.Methods A total of 60 patients with AIS admitted to the department of massage of the Third Affiliated Hospital of Zhejiang Chinese Medical University from October 2016 to October 2020 were selected and divided into the observation group(n=30)and the control group(n=30)according to the random number table method.The control group was treated with conventional massage and bone setting manipulation,while the observation group was treated with lever positioning manipulation based on conventional massage and bone setting.The data of thoracic kyphosis angle(TK),lumbar lordosis angle(LL),pelvic incidence angle(PI),pelvic tilt angle(PT),sacral slope angle(SS),T1 pelvic angle(TPA)and spinal sagittal vertical axis(SVA)were statistically analyzed before and 8 weeks after treatment,and the sagittal parameter changes of spinal-pelvic were evaluated.Results Before treatment,there were no statistically significant differences in TK,LL,PI,PT,SS,TPA and SVA between the two groups(P>0.05).Compared with before treatment,there were statistically significant differences in TK,LL,PI,PT,SS,TPA and SVA in each group after treatment(P<0.05).After treatment,there were statistically significant differences in TK,LL,PI and TPA between the observation group and the control group(P<0.05).However,there were no statistically significant differences in PT,SS and SVA between the observation group and the control group(P>0.05).Conclusion Lever positioning can effectively restore the pelvic parameters,change the pelvic anteversion state of AIS patients,and thus restore the curvature of thoracolumbar spine and achieve the balance between spine and pelvic sagittal torso.