摘要
目的通过影像学研究颈椎后前向松动和牵引的同时行后前向松动产生的椎间运动，并对比分析。方法选取正常受试者12例，其中男6例，女6例；年龄18～25岁，平均年龄（22．9±4．7）岁；平均身高为（1．64±0．07）m；平均体重（54．7±7．6）kg。12例受试者均接受单纯的后前向关节松动（单纯松动术）和牵引的同时行后前向松动（牵引松动术），于每种治疗方法开始前及治疗结束后（治疗后）行x线片采集，采用四张静态颈椎侧位片，收集前椎间隙、后椎间隙、后关节突关节间隙的轴向位移及椎体前后位移，每次治疗前、后的变化率，以及运动节段矢状面的旋转和移动变化率。结果治疗后，单纯松动术在C2～C7矢状面旋转角度变化之和均显著高于牵引松动术（P〈0．05）；单纯松动术在C5节段前椎间隙以及C2～C7前椎间隙之和均显著高于牵引松动术（P〈0．05），而牵引松动术后椎间隙以及C2～C7后关节突间隙均显著高于单纯松动术（P〈0．05），单纯松动术和牵引松动术椎体的前、后位移，2组间差异无统计学意义（P〉0．05），单纯松动术C2～C7椎体与基线相比产生向后位移，牵引松动术C2～C7椎体与基线相比产生向后位移，而C6产生向前位移。结论单纯松动术可明显增加C2～C7，脊柱的前凸，减小后椎间隙和后关节突间隙，而牵引松动术可改变其椎间运动。
Objective To compare the cervical intervertebral movements produced by posteroanterior cervi- cal mobilization and posteroanterior cervical mobilization combined with cervical traction by using the radiographic measurement. Methods The study recruited 12 normal volunteers （6 men,6 women） , aged 18 to 25 years （22.9 ±4.7 years）, heighted （164 ± 7 ）em and weighed （54.7 ± 7.6）kg. All the subjects were administered with pos- teroanterior cervical mobilization followed by posteroanterior cervical mobilization while having cervical traction, or vice versa, with an interval of 2 days in between. The X-ray films were collected before and after the treatment, using 4 static cervical lateral views. The axial displacement of posterior and anterior intervertebral separation （IVS） , and the shear displacement of vertebral body as well as the rotation and displacement rate of the motion segments in the sagittal plane before and after the treatment were measured on the radiographic images and compared. Results It was shown that the posteroanterior cervical mobilization produced greater C2-C7 rotation range of motion in the sagittal plane, as compared to that by the posteroanterior mobilization while having cervical traction （P 〈 0.05）. The pos- teroanterior mobilization produced a significantly greater increase of anterior IVS of the C5 segment and the summation of C2-C7 posterior IVS than those by posteroanterior mobilization while having cervical traction （P 〈 0.05 ）. However, the posterior IVS and the posterior zygapophysial joints separation of Cz-C7 produced by the postcroanterior mobiliza- tion during traction were more prominent （P 〈 O. 05 ）. There was no statistical difference between anteroposterior dis- placements of the vertebral body produced by the two interventions. Comparing with the baseline, the posteroanterior mobilization caused posterior movement of the vertebral bodies of C5 to Cz , while the posteroanterior cervical mobiliza- tion during traction produced posterior movement of C5 to C2 vertebral bodies and anterior movement of C6 body. Conclusion The cervical posteroanterior mobilization significantly increased the lordosis from C3 to C7 , and reduced posterior IVS and zygapophysial .joints separation. However, the posteroanterior mobilization during traction cllangcd changed the interverrtebral movements.
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2012年第12期937-941,共5页
Chinese Journal of Physical Medicine and Rehabilitation
基金
华中科技大学自主创新基金交叉学科项目（J2009003）
关键词
单纯松动术
牵引松动术
X线分析
椎间运动
Posteroanh,rior mobilizalion
Posleroanlerior mobilizalion during traction
X-ray image
luter
＇en＇tebval II＇）OV（＇In~＇IIIS
