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牵引对腰椎间盘的力学影响:一项磁共振成像研究。

Mechanical effects of traction on lumbar intervertebral discs: A magnetic resonance imaging study.

机构信息

Department of Health & Physical Education, The Education University of Hong Kong, 10 Lo Ping Road, Tai Po, N.T., Hong Kong Special Administrative Region.

Department of Diagnostic Radiology, Tuen Mun Hospital, 23 Tsing Chun Koon Road, Tuen Mun, N.T., Hong Kong Special Administrative Region.

出版信息

Musculoskelet Sci Pract. 2017 Jun;29:78-83. doi: 10.1016/j.msksp.2017.03.007. Epub 2017 Mar 20.

Abstract

BACKGROUND

Although traction has long been used for treating patients with low back pain (LBP), its effects are still inconclusive mainly because of limited high-quality evidence.

OBJECTIVE

To provide evidence of the mechanism of traction on lumbar intervertebral discs.

DESIGN

A quantitative approach with a repeated measurement protocol.

METHOD

Nine participants (mean age = 22.1 ± 0.8 years) without any LBP history were recruited. Magnetic Resonance Images of the lumbar spine of each participant were recorded before and after 30 min of horizontal lying and directly after 30 min of horizontal traction of 42% body weight. The average, anterior, central, and posterior disc height and tilt angle of each lumbar disc and lumbar lordosis were measured.

RESULTS

A significant increase in the average disc height for all lumbar discs, a significant reduction of lumbar lordosis and changes in tilt angle were observed after the application of 30 min of resting followed by 30 min of traction. A significant increase in the average disc height was observed only in lower lumbar discs after 30 min of traction. The increase in the posterior disc height was more apparent than that in the anterior disc height.

CONCLUSIONS

Horizontal traction was evidently effective in increasing the disc height of lower lumbar levels, particularly in the posterior regions of the discs. Further evidence of the effects of traction of different modes, magnitudes, and durations on the change in disc height is required for proper control of traction applied to specific disc levels.

摘要

背景

尽管牵引疗法长期以来一直被用于治疗腰痛(LBP)患者,但由于高质量证据有限,其效果仍不确定。

目的

提供牵引对腰椎间盘作用机制的证据。

设计

具有重复测量方案的定量方法。

方法

招募了 9 名无腰痛史的参与者(平均年龄 22.1 ± 0.8 岁)。在水平卧位 30 分钟前后以及水平牵引 42%体重 30 分钟后,对每位参与者的腰椎磁共振图像进行了记录。测量了每个腰椎间盘的平均、前、中、后椎间盘高度和倾斜角以及腰椎前凸角。

结果

在 30 分钟的休息后进行 30 分钟的牵引后,观察到所有腰椎间盘的平均椎间盘高度显著增加,腰椎前凸角显著减小,倾斜角发生变化。仅在牵引 30 分钟后,下腰椎间盘的平均椎间盘高度显著增加。后椎间盘高度的增加比前椎间盘高度明显。

结论

水平牵引显然有效地增加了下腰椎间盘的高度,特别是在椎间盘的后区域。需要进一步研究不同模式、幅度和持续时间的牵引对椎间盘高度变化的影响,以便对特定椎间盘水平的牵引进行适当控制。

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