摘要
目的:观察牵引力对腰椎间盘突出症患者的腰椎间盘突出物的生物学效应。方法:①44例住院患者,为南京医科大学附属南京第一医院骨科和黑龙江中医药大学附属第一医院骨科1992/2006收治。男29例,女15例,年龄19～73岁,平均(39.6±1.2)岁,病程0.5～144个月,平均(39.6±26.9)个月。根据腰腿痛,直腿抬高试验阳性和CT、MRI检查有腰椎间盘突出等,诊断为腰椎间盘突出症。②手术中打开椎管后,直接测量牵引前突出物高度;再固定胸部和踝部,对抗牵引15min,牵引物质量40kg,测量牵引中的突出物高度;最后,放松牵引5min后测量牵引后的突出物高度。结果:44例患者均进入结果分析,41例患者牵引后突出物高度有不同程度的回缩,其余3例无变化。牵引前突出物平均高度高于牵引中和放松牵引后[(6.44±1.99),(4.04±1.60),(5.18±1.48)mm,P<0.001,0.01];牵引中突出物平均高度小于牵引后(P<0.01)。结论:牵引力确实能使大部分患者的腰椎间盘突出物部分回纳,但难以维持。经过反复牵引,突出物便交替回纳和再突出,最终形状有所改变,对神经根的压迫减轻,临床症状可以减轻或消除。对于神经根周围有粘连的患者,牵引可能无效。
AIM： To observe the biological effects of lumbar traction on the herniated nucleus pulposus （HNP） in patients with lumbar disc herniation （LDH）. METHODS： ①Forty-four inpatients with LDH were selected from Department of Orthopedics, First Hospital of Nanjing Medical University and Department of Orthopedics, First Hospital of Heilongjiang University of Chinese Medicine, including 29 males and 15 females aged 19-73 years, average of （39.6±1.2） years and 0.5-144 months disease course, a mean of （39.6±26.9） months. They were diagnosed by their back or legs pain, positive Laseque sign and lumbar disc hemiation in CT scan or MRI. ②The heights of HNP were measured directly after opening the spinal canal, during a lumbar traction of 40 kg for 15 minutes and 5 minutes after the traction was relaxed. RESULTS： Forty-four cases were involved in the result analysis, of which 41 were found decrease in the heights of HNP after traction, and the other 3 had no changes. The average height of HNP before traction was higher than that during and after traction [（6.44±1.99）, （4.04±1.60）, （5.18±1.48） mm, P 〈 0.001, 0.01]; the height of HNP during traction was lower than that after traction （P 〈 0.01）. CONCLUSION： Lumbar traction can make the HNP partial regress in a short term. Repeated traction causes the altemative regression and re-protrusion of HNP, and finally leads to shape changes to some extent, so that it could relieve clinical symptoms by removing direct pressure .from neural tissue. Traction may be useless for those with adhesion around nerve root.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第36期7173-7175,共3页
Journal of Clinical Rehabilitative Tissue Engineering Research
