斜向牵拉手法对骶髂关节生物力学影响的尸体研究。
Effects of manipulations of oblique pulling on the biomechanics of the sacroiliac joint: a cadaveric study.
机构信息
Department of Spine Surgery, The First Affiliated Hospital，Hengyang Medical School, University of South China, Hengyang, Hunan Province, China.
School of Traditional Chinese Medicine, Southern Medical University, Guangdong Province, Guangzhou, China.
出版信息
BMC Musculoskelet Disord. 2023 Jan 23;24(1):55. doi: 10.1186/s12891-023-06175-6.
BACKGROUND
There are many reports on the treatment of sacroiliac joint dysfunction by manipulation of oblique pulling (MOP). However, the specific mechanism of MOP on the sacroiliac joint remains unclear. This study aimed to investigate the effect of MOP on the biomechanics of the sacroiliac joint and the effect of the anterior sacroiliac ligament on the stability of the sacroiliac joint.
METHODS
First, MOP-F1 (F: force) and MOP-F2 were applied to nine cadaveric pelvises. Then, segmental resection of the anterior sacroiliac ligament was performed. The range of motion of the sacroiliac joint was observed in all procedures.
RESULTS
Under MOP-F1 and F2, the average total angles were 0.84° ± 0.59° and 1.52° ± 0.83°, and the displacements were 0.61 ± 0.21 mm and 0.98 ± 0.39 mm, respectively. Compared with MOP-F1, MOP-F2 caused greater rotation angles and displacements of the sacroiliac joint (p = 0.00 and p = 0.01, respectively). In addition, the rotation angles and displacements of the sacroiliac joint significantly increased after complete resection of the anterior sacroiliac ligament (p = 0.01 and p = 0.02, respectively). The increase was mainly due to the transection of the upper part of the anterior sacroiliac ligament.
CONCLUSIONS
MOP-F2 caused greater rotation angles and displacements of the sacroiliac joint and was a more effective manipulation. The anterior sacroiliac ligament played an important role in maintaining the stability of the sacroiliac joint; the upper part of the anterior sacroiliac ligament contributed more to the stability of the joint than the lower part.
背景
有许多关于斜向牵引推拿（MOP）治疗骶髂关节功能障碍的报道。然而，MOP 对骶髂关节的具体作用机制尚不清楚。本研究旨在探讨 MOP 对骶髂关节生物力学的影响以及前骶髂韧带对骶髂关节稳定性的影响。
方法
首先，对 9 具尸体骨盆进行 MOP-F1（F：力）和 MOP-F2 操作。然后，行前骶髂韧带节段性切除。观察所有操作过程中骶髂关节的活动范围。
结果
在 MOP-F1 和 F2 下，骶髂关节的总平均角度分别为 0.84°±0.59°和 1.52°±0.83°，位移分别为 0.61±0.21mm 和 0.98±0.39mm。与 MOP-F1 相比，MOP-F2 引起骶髂关节的旋转角度和位移更大（p=0.00 和 p=0.01）。此外，完全切除前骶髂韧带后，骶髂关节的旋转角度和位移明显增加（p=0.01 和 p=0.02）。这种增加主要是由于前骶髂韧带上部的横断。
结论
MOP-F2 引起骶髂关节的旋转角度和位移更大，是一种更有效的推拿手法。前骶髂韧带在维持骶髂关节稳定性方面起着重要作用；前骶髂韧带的上部比下部对关节的稳定性贡献更大。
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