观察定点侧屈旋扳整颈手法对神经根型颈椎病椎间孔的形态学改变
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1.天津中医药大学第一附属医院;2.天津医院;3.国家中医药管理局区域中医骨伤科诊疗中心

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To observe the morphological changes of intervertebral foramina in cervical spondylotic radiculopathy by fixed-point lateral flexion manipulation
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    摘要:

    [摘要]:目的:基于三维重建技术分析定点侧屈旋扳整颈手法治疗神经根型颈椎病患者椎间孔形态的变化,为手法治疗的有效性提供依据。方法:收集2020年9月-2021年5月于天津中医药大学第一附属医院骨伤科门诊或病房收治的神经根型颈椎病患者40例,均予定点侧屈旋扳整颈手法治疗,隔日一次,共治疗7次,2周为一疗程。借助16排多功能CT、Mimics 21.0、Geomagic、Solidworks 2017软件对患者治疗前后的CT数据进行三维重建分析,分别测量患者治疗前后的椎间孔面积、椎间孔前后径、椎间孔上下径和红外热成像温差值(双侧颈肩部、上肢前侧、上肢后侧),并观察患者治疗前、治疗7天后、治疗14天后、1月随访时的VAS评分,使用SPSS 21软件对所得数据进行统计分析。结果:40例患者治疗后的椎间孔面积、椎间孔前后径、椎间孔上下径较治疗前均得到改善,差异均具有统计学意义(P<0.05),两组患者的红外热成像温差值(△T):治疗前后差异均具有统计学意义(P<0.05)。两组患者的VAS评分呈逐级递减式下降,且且重复测量方差分析P<0.05,差异有统计学意义。结论:定点侧屈旋扳整颈手法可以显著改善神经根型颈椎病患者的椎间孔形态,以此达到解除神经压迫,达到治疗目的,为定点侧屈旋扳整颈手法治疗神经根型颈椎病的临床疗效提供依据和证据。

    Abstract:

    【Abstract】Objective: To analyze the changes in the morphology of intervertebral foramina in patients with radiculocervical spondylotic radiculopathy treated with fixed-point lateral flexion and rotation manipulation based on three-dimensional reconstruction technology, so as to provide evidence for the effectiveness of manipulation treatment.Methods: Ten patients with radiculopathic cervical spondylopathy who were admitted to the orthopedic outpatient department or ward of the First Affiliated Hospital of Tianjin University of Chinese Medicine from March 2019 to November 2019 were treated with fixed point lateral flexion and neck-pulling manipulation once every other day for a total of 7 times and 2 weeks as a course of treatment.The CT data before and after treatment were analyzed by using 16 rows of multifunctional CT, Mimics 21.0, Geomagic and Solidworks 2017. The area of intervertebral foram, diameter of intervertebral foram, diameter of intervertebral foram and diameter of intervertebral foram before and after treatment were measured respectively. SPSS 21 software was used for statistical analysis of the obtained data.Results: After treatment, the area of foramina, diameter of foramina, diameter of foramina and diameter of foramina were all improved, and the differences were statistically significant (P<0.05).Conclusion: Fixed-point lateral flexion and rotation manipulation can significantly improve the shape of intervertebral foramina in patients with radiculopathy. This study provides evidence for the clinical efficacy of fixed-point lateral flexion and rotation manipulation in the treatment of radiculopathy.

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  • 收稿日期:2021-07-05
  • 最后修改日期:2021-08-16
  • 录用日期:2021-08-23
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