摘要
目的在评价手法治疗不同类型腰椎滑脱症疗效的基础上,研究腰椎滑脱分型的临床意义。方法按照影像学症状的不同将我院收治的120例腰椎滑脱症患者分为腰痛症状组40例,伴神经根症状组40例,伴椎管症状组40例。入院后三组患者均行相同方案的手法治疗,评价临床治疗效果;并于患者治疗前后采用疼痛视觉模拟评分法(VAS)对患者的疼痛症状进行评分,参照日本矫形外科学会(JOA)下腰痛评分表对患者的下腰痛症状进行评分;同时予以患者X线检查,测定患者腰椎平行位移值和角度位移值。结果在临床治疗总有效率上,腰痛症状组、伴神经根症状组、伴椎管症状组依次为91.67%、88.56%、72.22%,腰痛症状组、伴神经根症状组均高于伴椎管症状组(P<0.05)。治疗后,在平均VAS评分、平均JOA评分各指标改善幅度上,腰痛症状组、伴神经根症状组均大于伴椎管症状组(P<0.05)。治疗后,腰痛症状组、伴神经根症状组患者腰椎平均平行位移值、角度位移值较治疗前均减小(P<0.05);但伴椎管症状组患者治疗前后较治疗前无明显变化(P>0.05)。结论手法治疗腰痛症状和伴神经根症状腰椎滑脱症的疗效要显著优于伴椎管症状患者,临床上可在依据该症状进行分型的基础上优选该方法予以腰痛症状和伴神经根症状腰椎滑脱症患者的治疗,以提高临床疗效。
Objective To study the clinical significance of lumbar spondylolisthesis based on the evaluation of the therapeutic effects of manual treatment in different types of lumbar spondylolisthesis.Methods According to the different imaging symptoms,120patients with lumbar spondylolisthesis admitted in our hospital were divided into40cases in low back pain symptom group,40cases in nerve root symptom group and40cases in spinal canal symptom group.After admission,the patients in the three groups were treated with the same regimen and the clinical treatment effect was evaluated.The pain symptoms of patients were scored by the pain visual analogue scale(VAS)before and after treatment.The low back pain was scored referring to the Japanese Society of Orthopaedic Surgery(JOA).The patients were also examined by X-ray.The lumbar parallel displacement and angular displacement values were determined.Results The total effective rate of clinical treatment in the low back pain symptom group,the ganglion symptom group and the spinal canal symptom group were91.67%,88.56%,and72.22%,respectively.And the total effective rate of clinical treatment in the low back pain symptom group,the ganglion symptom group was higher than that of the spinal canal symptom group(P<0.05).After treatment,the improvement of the mean VAS score and the average JOA score was higher in the low back pain symptom group and the ganglion symptom group than that in the spinal canal symptom group(P<0.05).After treatment,the average parallel displacement value and angular displacement value of the lumbar vertebrae group and the nerve root symptom group were lower than those before treatment(P<0.05).However,the patients with spinal canal symptoms had no significant change before and after treatment(P>0.05).Conclusion Therapeutic effect of lumbar spondylolisthesis and lumbar spondylolisthesis with ganglion symptoms is significantly better than that of patients with spinal canal symptoms.It is clinically possible to use this method to determine the symptoms of low back pain and radiculopathy in patients with lumbar spondylolisthesis based on the classification of the symptoms,so as to improve clinical outcomes.
作者
耿文东
GENG Wendong(Department of Tendons, Foshan Jianxiang Hospital in Guangdong Province, Foshan 528000, China)
出处
《中国现代医生》
2018年第32期107-110,共4页
China Modern Doctor
基金
广东省佛山市卫生和计生局科研基金支持项目(20170162)
关键词
腰椎滑脱症
手法治疗
临床分型
腰椎位移
腰痛
Lumbar spondylolisthesis
Manual therapy
Clinical classification
Lumbar displacement
Low back pain
