Broetz Doris, Hahn Ulrich, Maschke Evelin, Wick Wolfgang, Kueker Wilhelm, Weller Michael
Department of General Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, Germany.
NeuroRehabilitation. 2008;23(3):289-94.
Lumbar disk prolapses are among the most common neurological conditions. In this open study, we asked whether repeated end-range spinal movements (McKenzie method) as physiotherapy in patients with lumbar disk prolapse induce early changes in location, size and signal intensity of lumbar disc material detectable by magnetic resonance imaging (MRI). We compared clinical with radiographic changes. The clinical efficacy of mechanical physiotherapy according to the McKenzie method within 5 days was documented.
Eleven consecutive patients with lumbar disk prolapse were included. Patients were treated with repeated end-range spinal movements and MRI was performed before and after 2-5 treatments.
All patients achieved a reduction in symptoms and signs of disk prolapse during and after these procedures but none showed any change in the MRI features of the prolapses.
Beneficial effects of specific mechanical physiotherapy in patients with radicular syndromes from lumbar disk prolapse are not paralleled by changes in the MRI appearance of the prolapses. Alternative explanations for the early clinical responses in some patients with lumbar disc prolapse treated according to the McKenzie method must be sought.
腰椎间盘突出症是最常见的神经系统疾病之一。在这项开放性研究中，我们探讨了对于腰椎间盘突出症患者，采用反复终末位脊柱运动（麦肯齐疗法）作为物理治疗，是否会引起磁共振成像（MRI）可检测到的腰椎间盘物质在位置、大小和信号强度方面的早期变化。我们将临床变化与影像学变化进行了比较。记录了按照麦肯齐疗法在5天内进行机械物理治疗的临床疗效。
纳入11例连续的腰椎间盘突出症患者。对患者进行反复终末位脊柱运动治疗，并在2 - 5次治疗前后进行MRI检查。
所有患者在这些治疗过程中及治疗后，椎间盘突出的症状和体征均有所减轻，但MRI显示的椎间盘突出特征均未出现任何变化。
腰椎间盘突出所致神经根综合征患者接受特定机械物理治疗的有益效果，并未伴有椎间盘突出MRI表现的改变。对于一些按照麦肯齐疗法治疗的腰椎间盘突出症患者的早期临床反应，必须寻找其他解释。
