Department of TCM Manipulative Orthopedics, Air Force General Hospital of PLA, Beijing 100142, P.R. China.
Department of Sinew Injury Manual Therapy Research, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, P.R. China.
Mol Med Rep. 2018 Dec;18(6):5709-5716. doi: 10.3892/mmr.2018.9591. Epub 2018 Oct 25.
The present study aimed to investigate the differences in human lumbar intradiscal pressure (IDP) characteristics during simulated spinal manipulation and spinal mobilization. A total of 12 adult fresh lumbar spinal specimens (T12‑S2) were randomly divided into two groups. The parameters of simulated spinal mobilization were as follows: Preload angle, 15˚ (speed, 3˚/sec); maximum angle, 20˚ (speed, 1˚/sec); and 9 N horizontal force to the L5 spinous process. The parameters of simulated spinal manipulation were as follows: Preload angle, 15˚ (speed, 3˚/sec); impulse angle, 20˚ (impulse speed, 33˚/sec) and 22 N horizontal force to the L5 spinous process. The maximal IDP during both techniques was greater than the initial and end pressures (P<0.01). There was no difference between the initial and end IDP (P>0.05). The maximal IDP on the rotating side was greater than that on the contralateral side during the two techniques (P<0.05). There was no difference in both initial and end IDPs between the two sides (P>0.05). There was no difference in the maximal IDP between the two techniques (P>0.05). The ascending speed of IDP during manipulation was faster than during mobilization (P<0.01), while there was no difference in the descending speed between the two techniques (P>0.05). The maximal IDP on the rotating side was greater than the contralateral side during simulated spinal mobilization and manipulation (P<0.05). The ascending speed of IDP was faster during manipulation than mobilization (P<0.01). Therefore, thrust manipulation may have more instant impact to discs than mobilization.
本研究旨在探讨模拟脊柱推拿和脊柱松动手法时人腰椎间盘内压力(IDP)特征的差异。共 12 个成人新鲜腰椎标本(T12-S2)随机分为两组。模拟脊柱松动手法的参数如下:预加载角度 15°(速度 3°/秒);最大角度 20°(速度 1°/秒);L5 棘突水平施加 9 N 的力。模拟脊柱推拿手法的参数如下:预加载角度 15°(速度 3°/秒);脉冲角度 20°(脉冲速度 33°/秒),L5 棘突水平施加 22 N 的力。两种技术的最大 IDP 均大于初始和终末压力(P<0.01)。初始和终末 IDP 之间无差异(P>0.05)。两种技术时旋转侧的最大 IDP 大于对侧(P<0.05)。两侧初始和终末 IDP 之间无差异(P>0.05)。两种技术的最大 IDP 之间无差异(P>0.05)。推拿时 IDP 的上升速度快于松动时(P<0.01),而两种技术的下降速度无差异(P>0.05)。模拟脊柱松动和推拿时,旋转侧的最大 IDP 大于对侧(P<0.05)。推拿时 IDP 的上升速度快于松动时(P<0.01)。因此,推冲手法对椎间盘的即时影响可能大于松动手法。