胸腰椎骨折筋伤与腰背痛关系的临床研究

为了解胸腰椎压缩程度、筋伤状况与腰背痛之间的关系.选择56例单纯性稳定型胸腰椎压缩性骨折患者,采取早期垫枕静卧、腰背臀痛点分理揉按、适时功能锻炼和中药热熨等治疗,以椎体的压缩程度、腰背臀痛点的压痛程度以及腰背痛程度为观察指标,评价治疗效果和分析探讨骨折、筋伤与腰背痛之间的关系.结果腰背痛程度与胸腰椎的压缩程度不成正比,而与腰背臀部痛点的多少及压痛程度成正比,腰背疼痛程度随腰背臀痛点压痛程度的减轻而改善,与压缩椎体的恢复程度不成正比.说明胸腰椎发生压缩性骨折的同时,腰背部筋伤已客观存在,是引起伤后腰背痛的主要原因.注重早期筋伤治疗,有助于消除腰背疼痛、减少后遗腰背痛的发生.

A CLINICAL STUDY ON THE RELATION OF THORACOLUMBAR VERTEBRAL FRACTURE AND SOFT-TISSUE INJURY TO LUMBAGO

In order to understand the relation of the thoracolumbar vertebral compression degree and the soft-tissue injury severity to lumbago, 56 cases of simple stable thoracolumbar vertebral compression fracture were treated by early lying still with pillow pad, smoothing out and kneading and pressing the pain spots in the back and buttock, timely functional exercises and hot TCD-medicated compression, etc, and the degrees of vertebral body compression, pain spots tenderness and lumbago were taken as the observed indices to evaluate the treatment results and to analyze and explore the relation of the fracture and soft-tissue injury to lumbago. The results showed that lumbago is positively related not to the thoracolumbar vertebral compression degree but to tenderness degree and pain spots number in the back and buttock; the lumbago degree could be improved as the pain spots tenderness is abated but not positively related to the recovery of the compressed vertebral body, suggesting that when the compression fracture occurs, the soft-tissue injury exists already, which is the main cause for the post-injury lumbago; the early treatment of soft-tissue injury helps to remove the lumbago and decrease the residual lumbago incidence.