摘要
目的评价不同推拿手法对腰椎运动单元生物力学影响的差异,探讨不同推拿方法治疗腰椎间盘退变疾患所致腰腿痛的可能作用机制。方法选取6具新鲜成年猪腰椎标本,模拟斜扳(无纵向拔伸及压缩力,扭矩分别为0、1、2 Nm)及牵扳(纵向拔伸力=250 N,扭矩分别为0、1、2 Nm)手法,即六种加载方案,完全随机作用于每一具标本上,通过测量六种加载方法作用前后标本椎间盘内压力(L3/4)、关节突关节内压力及椎间高度(L3/4)的变化情况,评价斜扳与牵扳手法对猪腰椎运动单元的生物力学改变情况。结果 (1)椎间盘内压力变化:加载前后椎间盘内压力的瞬时值变化:斜扳之后椎间盘内压力升高,无统计学意义;牵扳之后椎间盘内压力减低,有统计学意义(P=0.005)。(2)椎间高度变化:斜扳组的椎间高度较之前的椎间盘高度的变化无统计学差异,牵扳组的椎间高度较之前的椎间高度增加,有统计学意义(P=0.001)。(3)压敏片结果:斜扳组及牵扳组都能使小关节压力增加,有统计学意义(P<0.05),并且扭矩越大,关节突关节压力增加越大。牵扳组与斜扳组之前无统计学差异。结论斜扳使椎间盘内压力增加,但对椎间高度的影响不明显;牵扳使椎间盘内压降低且能使椎间高度增高;无论斜扳还是牵扳,只要加扭矩就会增加关节突关节压力,而且扭矩越大,关节突关节压力增加越明显。
Objective To simulate to two kinds of spinal manipulation that impose different torsion on isolated pig lumbar vertebrae. Methods Six fresh lumbar spine specimens from adult pigs were selected. Six loading programs were formulated by the usage of material testing system to stimulate oblique- pulling manipulation （no longitudinal traction and torques were 0,1,2 Nm respectively） and traction-rotation manipulation （longitudinal traction=250 N, torques were 0,1,2 Nm respectively）. With the roles of the programs played on each specimen randomly, the biomechanical changes of porcine lumbar spine specimens caused by passive vertebral rotation were evaluated. It was achieved by measurement of changes of pressure in specimens＇ nucleus pulposus （L3/4） and in facet joints and disc height before and after the six programs. Results （1） Pressure in nucleus pulposus： Changes of instantaneous value of pressure in nucleus pulposus： pressure elevated after oblique-pulling manipulation showed no statistical significance; pressure reduced after traction-rotation manipulation showed statistical significance （P=0.005）; （2） Changes of disc height： compared with before, the changes of disc height in oblique-pulling group showed no statistical differences; however, disc height of traction-rotation group was higher than that of before, demonstrating statistical significance（P=- 0.001 ）. （3） Results of pressure sensitive film： infrared scanning showed that pressure in facet joints could be elevated in both traction-rotation and oblique-pulling group, showing statistical significance （P〈0.05）. The larger the torque was, the higher the pressure was in facet joints. No statistical difference existed between traction-rotation and oblique-pulling groups. Conclusions Pressure in nucleus pulposus could be elevated by oblique-pulling manipulation and reduced by traction-rotation manipulation. Under traction-rotation manipulation, the increase of torques had an effect on disc height. However, the incr
出处
《中国临床解剖学杂志》
CSCD
北大核心
2014年第6期721-724,共4页
Chinese Journal of Clinical Anatomy
基金
湖南省中医药科研计划项目(项目编号:201190)
关键词
腰腿痛
推拿
生物力学
Low back and leg pain
Spinal manipulation
Biomechanics
