针刀治疗腰椎间盘突出症CT特征分析及机理探讨

目的观察针刀治疗腰椎间盘突出症疗效及治疗前后CT特征的变化,探讨针刀治疗机理。方法将160例腰椎间盘突出患者随机分为两组。治疗组90例运用针刀治疗,对照组60例运用侧隐窝阻滞治疗。治疗前及治疗后两年后均行CT检查并进行对比分析。结果两组总有效率具有显著性差异(P0.05);两组治疗后的突出物大小以及治疗组的椎间隙高度、椎体滑移度均无明显改变(P0.05),而对照组椎间隙高度、椎体滑移度改变有非常显著性差异(P0.01);治疗组神经根发生移位和神经根水肿消失或减轻情况比较,均显著高于对照组(P0.05)。结论针刀治疗主要通过调整腰椎力学平衡,阻滞或延缓脊柱失稳,松解椎间孔,扩大神经根的活动范围,使神经根移位避开突出物压迫来达到治疗LDH的目的。

Analysis and Mechanism Exploration of CT Characteristics of Lumbar Disc Herniation Treated by Acupotomy

Objective To observe the effect of lumbar disc herniation treated by acupotomy and changes of CT characteristics before and after the treatment, and to explore mechanism of acupotomy therapy. Method 160 eases of LDH were randomly divided into two groups. 90 cases of treatment group were treated by acupotomy. 60 cases of control group were treated by lateral recess nerve block. The CT was detected before the treatment and after 2 years＇ treatment, and these detection results ＂were analyzed. Result There is significant difference between two groups （P 〈 0.05 ）. After the treatment, the protruded size in two groups and intervertebral ahitud and vertebral body slippage in treat- ment group have no difference （ P 〉 0.05 ）. But in control group intervertebral altitud and vertebral body slippage are significant difference （ P 〈0.01 ）. Nerve root shift and nerve root edema disappearance or alleviation in treatment group are remarkably higher than the control group （ P 〈 0.05 ）. Conclusion Acupotomy treatment mainly adjusts biomechanics balance of lumbar vertebra, block or delay spinal column in- stability, release intervertebral foramen, enlarge the moving range for nerve root, and make the nerve root escape protuberance＇s pressure, which may result in cure of LDH.