| 曹 威,惠正广,夏梦娇,李朝顶,杨六中.腰椎间盘突出症正骨治疗后影像学参数演变及突出物重吸收相关因素分析——基于51例患者的回顾性队列研究[J].,2025,(18):2903-2910 |
| 腰椎间盘突出症正骨治疗后影像学参数演变及突出物重吸收相关因素分析——基于51例患者的回顾性队列研究 |
| Evolution of Imaging Parameters and Factors Associated with Herniated Disc Resorption after Spinal Manipulation Therapy in Lumbar Disc Herniation: a Retrospective Cohort Study of 51 Patients |
| 投稿时间：2025-05-08 |
| DOI：10.13241/j.cnki.pmb.2025.18.004 |
| 中文关键词: 腰骶部平衡 中医正骨 整脊疗法 腰椎间盘突出重吸收 |
| 英文关键词: Lumbosacral balance Chinese medicine bonesetting Chiropractic therapy Re-absorption of lumbar disc herniation |
| 基金项目:江苏省中医药科技发展计划项目（MS2023075） |
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| 中文摘要: |
| 摘要 目的：探讨中医调曲纠旋正骨手法对腰椎间盘突出症（LDH）患者脊柱生物力学参数的影响及突出物重吸收的相关因素。方法：回顾性分析2022年1月至2024年5月接受正骨治疗的51例LDH患者资料。通过治疗前、末次随访腰椎MRI测量腰骶部参数（α角、β角、SS角、LL角），依据MSU分型评估突出物重吸收情况。采用多因素Logistic回归分析重吸收的影响因素。结果：患者经正骨治疗后?琢角显著减小（3.02°→1.86°，P=0.002），SS角（28.4°→30.0°，P<0.001）、LL角（31.0°→35.12°，P<0.001）显著增大；56.86%（29/51）患者发生突出物重吸收。病程延长（OR=0.79，95%CI: 0.69-0.91）和突出物钙化（OR=0.03，95%CI: 0.00-0.25）是重吸收的独立阻碍因素（P<0.001）。结论：正骨手法通过恢复腰骶生物力学平衡（纠正椎体旋转、增大腰椎曲度）改善LDH症状，且病程短（≤6个月）、无钙化、MSU 2-3级患者更易发生重吸收。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of traditional Chinese curve-correcting and rotation-reducing spinal manipulation on biomechanical parameters and factors influencing herniated disc resorption in lumbar disc herniation (LDH). Methods: A retrospective analysis of 51 LDH patients treated between January 2022 and May 2024 was conducted. Lumbosacral parameters (vertebral rotation angle [α], disc angle [β], sacral slope [SS], lumbar lordosis [LL]) were measured via MRI before treatment and at final follow-up. Disc resorption was assessed using Michigan State University (MSU) classification. Multivariate logistic regression identified factors associated with resorption. Results: Post-treatment α angle significantly decreased (3.02°→1.86°, P=0.002), while SS (28.4°→30.0°, P<0.001) and LL angles (31.0°→35.12°, P<0.001) increased; Disc resorption occurred in 56.86% (29/51) of patients. Longer disease course (OR=0.79, 95%CI: 0.69-0.91) and disc calcification (OR=0.03, 95%CI: 0.00-0.25) were independent inhibitors of resorption (P<0.001). Conclusion: Spinal manipulation restores lumbosacral biomechanics by reducing vertebral rotation and increasing lumbar curvature, with higher resorption rates in patients with short duration (≤6 months), non-calcified discs, and MSU type 2-3 herniations. |
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