三步调衡手法治疗退行性腰椎滑脱症疗效观察

目的观察三步调衡手法治疗退行性腰椎滑脱症的临床疗效。方法应用三步调衡手法治疗退行性腰椎滑脱症患者41例,采用中文版Oswestry功能障碍指数(CODI)对临床疗效进行评价和随访观察,并对比观察椎体滑脱的变化情况。结果 CODI评分治疗前为(29.5±4.8)分,疗程结束为(9.9±5.3)分,改善率8.7%～93.5%,平均66.7%。根据疗效标准评价,优11例,良19例,可7例,差4例,总有效率90%,优良率73%。37例随访3个月,CODI评分(13.3±4.6)分,综合满意度优良率为76%(28/37),2例复发占5%。治疗前后滑脱程度比较,1例Ⅱ度滑脱变为Ⅰ度,2例Ⅰ度滑脱椎体序列恢复正常,其余病例滑脱分度无改变。结论三步调衡手法治疗退行性腰椎滑脱症有良好的近期效果;手法的作用机制不是以椎体复位为基础,而可能与腰椎动态平衡和稳定的重建有关。

Observation of curative effect of three-step Tiaoheng manuduction on degenerative spondylolisthesis

Objective It is to observe the clinical effect of three-step Tiaoheng manuduction on degenerative spondylolishesis.Methods 41 cases of patients with degenerative spondylolishesis were treated with three-step Tiaoheng manuduction.Clinical effect was evaluated and followed up with Chinese version of oswestry disability index(CODI),and the changes of basivertebral slip were observed and compared.Results CODI before treatment was(29.5±4.8) scores,and was(9.9±5.3)scores at the end of treatment.The improving rate was 8.7%-93.5%,and the average rate was 66.7%.According to the effect evaluating standard,there were 11 excellent cases,19 good cases,7 general cases and 4 bad cases,the total effective rate was 90%,excellent-good rate was 73%.37 cases were followed up for 3 months,CODI was(13.3±4.6)scores,excellent-good rate of total satisfied degree was 76%(28/37).There were 2 relapse cases(5%).Comparison of slip degree before treatment with that after treatment showed that one case of slip changed from II degree to I degree,two case of I degree recovered to normal level,the degree of the others didn’t change.Conclusion Three-step Tiaoheng manuduction has a good late effect on degenerative spondylolishesis.The mechanism of the manuduction is not basis on the vertebral body reposition,but it is may related with dynamic equilibrium of vertebral body and reconstruction of stability.