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颈椎牵引联合旋转手法对颈椎髓核压力的影响。

The effect of cervical traction combined with rotatory manipulation on cervical nucleus pulposus pressures.

作者信息

Li Y K, Zhu Q A, Zhong S Z

机构信息

Institute of Clinical Anatomy and Biomechanics, People's Liberation Army, First Military Medical University, GuangZhou, People's Republic of China.

出版信息

J Manipulative Physiol Ther. 1998 Feb;21(2):97-100.

PMID:9502065
Abstract

OBJECTIVE

To study experimentally the effect of cervical traction combined with rotatory manipulation on the pressure of the cervical nucleus pulposus.

DESIGN

Randomized experimental study.

SETTING

Institute of Clinical Anatomy and Biomechanics, the First Military Medical University, GuangZhou, China.

SUBJECTS

Twelve fresh cervical spines, from C7 to occipital bone, were obtained from cadavers of patients who had died from acute brain death.

INTERVENTION

State A: under different traction forces, the cervical spine was rotated. State B: the cervical spine was rotated first and then tractioned. State C: the cervical spine was tractioned and rotated simultaneously.

MAIN OUTCOME MEASURES

The cervical spine was tractioned and rotated by the Material Test System (MTS), and pressures of the cervical nucleus pulposus of C3-4, C4-5 and C5-6 were measured using pressure sensors.

RESULTS

(a) When the traction force increased, the pressure fell continuously in the 200-N tractioned spines; the pressure increased slightly when the sample was rotated. (b) The pressure fell to a certain extent when the state of cervical spine was restored. (c) In state A, the pressure fell obviously and increased slightly under a 200-N traction force and then the sample was rotated; in state B, the pressure first increased to a certain extent and then fell slightly and in state C, the pressure underwent no change in the main.

CONCLUSIONS

The results of this research suggest that rotatory manipulation of cervical spine under traction was the safest of the three procedures and the traction force used in clinical treatment may be a little smaller.

摘要

目的

通过实验研究颈椎牵引联合旋转手法对颈椎髓核压力的影响。

设计

随机实验研究。

单位

中国广州第一军医大学临床解剖与生物力学研究所。

对象

从急性脑死亡患者尸体上获取12个新鲜颈椎,从C7至枕骨。

干预

状态A:在不同牵引力下旋转颈椎。状态B:先旋转颈椎再进行牵引。状态C:颈椎牵引与旋转同时进行。

主要观察指标

使用材料测试系统(MTS)对颈椎进行牵引和旋转,并用压力传感器测量C3 - 4、C4 - 5和C5 - 6颈椎髓核的压力。

结果

(a)当牵引力增加时,在200 N牵引的颈椎中压力持续下降;样本旋转时压力略有增加。(b)颈椎恢复初始状态时压力有所下降。(c)在状态A中,在200 N牵引力下先明显下降,样本旋转时略有增加;在状态B中,压力先有一定程度增加,然后略有下降;在状态C中,压力总体无变化。

结论

本研究结果表明,牵引状态下的颈椎旋转手法是三种操作中最安全的,临床治疗中使用的牵引力可能应稍小一些。

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