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应用前凸曲线控制牵引后患者的功能变化及腰椎间盘的形态学变化:一项双盲随机对照研究

Functional Changes in Patients and Morphological Changes in the Lumbar Intervertebral Disc after Applying Lordotic Curve-Controlled Traction: A Double-Blind Randomized Controlled Study.

作者信息

Lee Chang-Hyung, Heo Sung Jin, Park So Hyun, Jeong Hee Seok, Kim Soo-Yeon

机构信息

Rehabilitation Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Korea.

Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Korea.

出版信息

Medicina (Kaunas). 2019 Dec 19;56(1):4. doi: 10.3390/medicina56010004.

Abstract

Lumbar traction is widely used as a non-operative treatment for lumbar intervertebral disc disease. The effect of traditional traction (TT) using linear-type traction devices remains controversial for various reasons, including technical limitations. Thus, the purpose of this study was to compare the effects of the newly developed lumbar lordotic curve-controlled traction (L-LCCT) and TT on functional changes in patients and morphological changes in the vertebral disc. A total of 40 patients with lumbar intervertebral disc disease at the L4/5 or L5/S1 level as confirmed by magnetic resonance imaging were recruited and divided into two groups (L-LCCT or TT). The comprehensive health status changes of the patients were recorded using pain and functional scores (the visual analogue scale, the Oswestry Disability Index, and the Roland-Morris Disability Questionnaire) and morphological changes (in the lumbar central canal area) before and after traction treatment. Pain scores were significantly decreased after traction in both groups ( < 0.05). However, functional scores and morphological changes improved significantly after treatment in the L-LCCT group only ( < 0.05). We suggest that L-LCCT is a viable option for resolving the technical limitations of TT by maintaining the lumbar lordotic curve in patients with lumbar intervertebral disc disease.

摘要

腰椎牵引作为腰椎间盘疾病的一种非手术治疗方法被广泛应用。由于包括技术限制在内的各种原因,使用线性牵引装置的传统牵引(TT)的效果仍存在争议。因此,本研究的目的是比较新开发的腰椎前凸曲线控制牵引(L-LCCT)和TT对患者功能变化及椎间盘形态变化的影响。通过磁共振成像确诊为L4/5或L5/S1水平腰椎间盘疾病的40例患者被招募并分为两组(L-LCCT组或TT组)。使用疼痛和功能评分(视觉模拟量表、Oswestry功能障碍指数和罗兰-莫里斯功能障碍问卷)以及牵引治疗前后的形态变化(腰椎中央管区域)记录患者的综合健康状况变化。两组牵引后疼痛评分均显著降低(<0.05)。然而,仅L-LCCT组治疗后功能评分和形态变化有显著改善(<0.05)。我们认为,L-LCCT通过维持腰椎间盘疾病患者的腰椎前凸曲线,是解决TT技术限制的一个可行选择。

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