Browning J E
J Manipulative Physiol Ther. 1989 Oct;12(5):369-73.
Mechanical disorders of the lumbar spine have been identified as a cause of pelvic pain and organic dysfunction (PPOD). Categorically, the clinical features indicative of mechanically induced PPOD fall into three areas: the history of the development or onset of pelvic symptomatology attributable to lower sacral nerve root compression (LSNRC), identification of related symptomatology on presentation, and the recognition of clinical findings indicative of mechanically induced PPOD on examination. Characteristic features of each category are presented. The clinical signs that most reliably indicate the presence of PPOD secondary to a mechanical lesion of the low back are of a sensory nature, and the disappearance or lack of improvement of these signs closely parallels the patient's overall response to manipulative treatment. Without a thorough understanding of the salient features of mechanically induced PPOD, the practitioner is likely to overlook this as a diagnostic possibility. As a result, efforts to document chiropractic spinal manipulative therapy in relieving disorders of pelvic organic function may be hampered. The empirical efficacy of chiropractic spinal manipulative therapy for treating disorders of pelvic organic function would be enhanced if more chiropractors were apprised of the salient features indicating the presence of mechanically induced PPOD.
腰椎机械性疾病已被确认为盆腔疼痛和器官功能障碍（PPOD）的一个原因。具体而言，提示机械性诱发PPOD的临床特征可分为三个方面：可归因于骶神经根受压（LSNRC）的盆腔症状的发展或发作史、就诊时相关症状的识别以及检查时提示机械性诱发PPOD的临床发现的识别。每个类别都呈现了其特征。最可靠地表明PPOD继发于下背部机械性损伤的临床体征是感觉性质的，这些体征的消失或缺乏改善与患者对手法治疗的总体反应密切相关。如果没有透彻理解机械性诱发PPOD的显著特征，从业者很可能会忽略这一诊断可能性。因此，记录整脊脊柱手法治疗缓解盆腔器官功能障碍的努力可能会受到阻碍。如果更多的整脊师了解表明存在机械性诱发PPOD的显著特征，整脊脊柱手法治疗对治疗盆腔器官功能障碍的经验性疗效将会提高。
