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[脊柱推拿治疗腰椎间盘突出症的历史与原理]

[The history and principle of spinal manipulation in the treatment of lumbar intervertebral disc herniation].

作者信息

Zhao Ping, Tian Qing

机构信息

Bonesetting Department of Combination of TCM with Western Medicine, General Air Force Hospital, Belling 100042, China.

出版信息

Zhongguo Gu Shang. 2009 Apr;22(4):276-8.

Abstract

It is generally agreed that spinal manipulation has been applied into the treatment of lumbar intervertebral disc herniation (LDH) for thousands of years according to historical reviews of the paper. The balance restore of spinal column had been always the main aim of spinal manipulation during the time. The situation has been changed after LDH was discovered pathomechanically about 70 years ago and the protruded nucleus pulposus has attracted the attention of whole world ever since and surgery become the major choice for LDH patients. Nevertheless, some latest reports of clinical observation in past decades explored more and more solid evidences to prove that most of the patients need no surgery at all and would be cured by conservative therapy without any changes of protruded nucleus pulposus at involved segment. The modern management of LDH suggests that we should not only pay attention to the protruded disk but also to the biomechanical balance of spinal column again as we had for thousands of years,which is concluded from the reviews of previous reports and history of LDH recognition in the paper. The only thing we should care more about is how to make full use of our modern knowledge to adjust our view of observation and management in clinical practice of spinal manipulation and to make a further understanding of the pathomechanics of LDH.

摘要

根据该论文的历史回顾,人们普遍认为脊柱推拿疗法应用于腰椎间盘突出症(LDH)的治疗已有数千年历史。在此期间,恢复脊柱平衡一直是脊柱推拿的主要目标。大约70年前,在从病理力学角度发现腰椎间盘突出症之后,情况发生了变化,自此突出的髓核吸引了全世界的关注,手术成为腰椎间盘突出症患者的主要选择。然而,过去几十年的一些最新临床观察报告探索出越来越确凿的证据,证明大多数患者根本不需要手术,通过保守治疗即可治愈,受累节段的突出髓核并无任何变化。该论文通过对先前报告和腰椎间盘突出症认识历史的回顾得出结论,现代腰椎间盘突出症的治疗方法表明,我们不仅应关注突出的椎间盘,还应再次关注脊柱的生物力学平衡,就像我们在过去几千年里所做的那样。我们唯一应该更加关注的是如何充分利用现代知识,调整我们在脊柱推拿临床实践中的观察和治疗观念,并进一步理解腰椎间盘突出症的病理力学。

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