文章摘要
梁杰,郑军凡,陈述荣,卢惠苹,张高飞,卢萍丹,陈昕.非手术脊柱减压系统治疗腰椎间盘突出症的疗效观察[J].中国康复,2019,34(11):579-582
非手术脊柱减压系统治疗腰椎间盘突出症的疗效观察
Clinical efficacy of Non-operative Spinal Decompression System for patients with lumbar disc herniation
  
DOI:
中文关键词: 非手术脊柱减压系统  腰椎间盘突出症  表面肌电  核磁共振
英文关键词: non-surgical spinal decompression system  lumbar disc herniation  surface electromyography  magnetic resonance imaging
基金项目:福州市重点专科建设项目(201710272);福建省自然科学基金项目(2019J01544);福建省卫生计生科研人才培养项目(2018-2-35);福州市科技计划项目(2018-S-101-4)
作者单位
梁杰 福州市第二医院福州 350007 
郑军凡 福州市第二医院福州 350007 
陈述荣 福州市第二医院福州 350007 
卢惠苹 福州市第二医院福州 350007 
张高飞 福州市第二医院福州 350007 
卢萍丹 福州市第二医院福州 350007 
陈昕 福州市第二医院福州 350007 
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中文摘要:
      目的:观察非手术脊柱减压系统对腰椎间盘突出症患者腰痛、腰椎活动功能和椎旁肌功能,以及腰椎间盘突出程度和椎间盘高度的疗效观察。方法:将40例腰椎间盘突出症(LDH)患者随机分为牵引组和非手术脊柱减压系统(SDS)组各20例。牵引组在常规康复治疗基础上予普通牵引治疗,SDS组在常规康复治疗基础上予SDS治疗。治疗前后,用视觉模拟(VAS)评分量表评估2组患者腰痛程度,日本骨科学会(JOA)下腰痛量表评估腰椎活动功能,表面肌电图评估椎旁肌功能,美国超导型核磁共振评估椎间盘突出指数(DHI)和椎间盘高度(DH)。结果:治疗6周后,2组患者VAS评分均明显低于治疗前(均P<0.05),JOA评分均明显高于治疗前(均P<0.05);SDS组VAS评分明显低于牵引组(P<0.05),JOA评分明显高于牵引组(P<0.05)。2组患侧竖脊肌和多裂肌平均肌电值(AEMG)均明显高于治疗前(均P<0.05);SDS组平均肌电值AEMG明显高于牵引组(P<0.05)。2组患者患侧竖脊肌和多裂肌平均功率频率斜率(MPFs)均明显高于治疗前(均P<0.05),SDS组MPFs明显高于牵引组(P<0.05)。2组患者病变节段DHI均明显低于治疗前(均P<0.05),DH明显高于治疗前(均P<0.05);SDS组DHI明显低于牵引组(P<0.05),但2组DH比较,差异无统计学意义。结论:SDS能明显减轻腰痛,改善LDH患者腰椎活动功能、椎旁肌功能和腰椎间盘突出程度,疗效优于普通牵引。
英文摘要:
      Objective: To observe the efficacy of Non-operative Spinal Decompression System (SDS) on the lumbar pain, lumbar motion function and paravertebral muscle function, the degree of lumbar disc herniation and disc height (DH) in the treatment of lumbar disc herniation. Methods: Forty cases of LDH were randomly divided into the traction group and SDS group (n=20 in each group). The traction group was given ordinary traction treatment on the basis of conventional rehabilitation, and SDS group was given SDS treatment on the basis of conventional rehabilitation. Before and after the treatment, the Visual Analog Scale (VAS) score was used to evaluate the degree of low back pain, Japanese Orthopaedic Society (JOA) Lower Lumbar pain scale was used to evaluate the lumbar motor function, surface electromyography was used to evaluate paraspinal muscle function, and MRI was used to evaluate the disk herniation index (DHI) and DH. Results: After 6 weeks of treatment, VAS score in both groups was significantly lower than that pre-treatment (all P<0.05), and JOA score was significantly higher than that pre treatment (all P<0.05). VAS score in SDS group was significantly lower than that in traction group (P<0.05), and JOA score was significantly higher than that in traction group (P<0.05). AEMG and MPFs of erector spinae and multifidus in both groups were significantly higher than those pre treatment (all P<0.05), and AEMG and MPFs in SDS group were significantly higher than those in traction group (P<0.05). DHI of the lesion segment in both groups was significantly lower than that pre treatment (all P<0.05), and DH was significantly higher than that pre-treatment (P<0.05). DHI in SDS group was significantly lower than that in traction group (P<0.05), but there was no significant difference in DH between two groups. Conclusion: SDS could effectively relieve pain, improve the function of lumbar and paravertebral muscle, and the degree of lumbar disc herniation of the LDH patients, and the effect is obviously better than that of the general traction.
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