The Establishment Of A Simulation Model Of Lumbar Instability Based On Quantitative Fluoroscopy And Its Application In The Evaluation Of Manipulative Effect

BackgroundLumbar instability is a common cause of low back and leg pain,and its incidence is relatively high in middle-aged and elderly people.Due to the lack of specific clinical symptoms and quantitative and objective imaging examination methods for lumbar instability,it has brought some troubles to clinical practice in terms of disease diagnosis,pathological mechanism research and efficacy evaluation.Traditional Chinese medicine manipulation treatment of lumbar instability has a good effect,but there is also a lack of quantitative,objective evaluation indicators,leading to the lack of in-depth research on the mechanism of manipulation treatment.Based on this,this paper attempts to apply quantitative fluoroscopy to the study of lumbar instability.Objective1.Lumbar imaging data were collected by quantitative fluoroscopy,and the Lumbar QF simulation model was established by KLT algorithm.2.The established lumbar QF simulation model was used to track and calculate the vertebral motion paraneters of patients with lumbar instability,and the correlation analysis was conducted with the clinical efficacy indexes of manipulation,so as to provide a quantitative and objective evaluation system for the treatment of lumbar instability.Methods1.Establishment of lumbar QF simulation model:Subjects were selected to perform lumbar extension,lateral flexion and rotation,and data such as edge processing,Angle detection and vertebral tracking were collected by dynamic X-ray technology.The Lumbar QF simulation model was established by KLT algorithm.Then the tracking effect of the model was verified on the real human body.2.Lumbar QF simulation model used to approach the curative effect of treating lumbar instability syndrome evaluation:selection of lumbar spinal instability,through randomized to massage the waist eore muscle group exercises,a simulation model with lumbar QF tracking calculation made before and after treatment of lumbar spinal sagittal/coronal dynamic image parameters,at the same time to collect clinical evaluation index(JOA score,ODI,QBPDS,LBOS),the correlation analysis between the two.Results1.Successful establishment of lumbar QF simulation model:This study confirmed that the KLT algorithm based on Harris feature points had a good effect in speed and tracking.Subsequently,a lumbar QF simulation model was established based on KLT algorithm.2.In terms of clinical efficacy analysis,JOA score,Oswestry disorder score were compared before and after treatment,and the difference between the two groups was statistically significant(P<0.05).The manipulation group had better effect than the exercise group.3.The lumbar QF simulation model was used to track and collect vertebral motion parameters of patients with lumbar instability.In sagittal plane,the changes of rotation and displacement of the sagittal position of the vertebral body before and after manipulation were compared in the group,and manipulation treatment had an obvious effect on improving the degree of lumbar relaxation.Changes in vertebral motion before and after treatment can eventually be expressed in precise digital form through quantitative fluoroscopy.However,the lumbar core muscle training in a short period of time through quantitative fluoroscopy measured by each parameter,the vertebral body before and after treatment did not change significantly.Owstry score in manipulation group was significantly correlated with hC and relaxation degree of L4 vertebrae,hA,hC and relaxation degree of L5 vertebrae,and JOA score was significantly correlated with hC and hA and hC of L4 vertebrae.In the exercise group,Owstry score was correlated with hA and hC in L5 vertebrae,while JOA score was correlated with hA and hC in L5 vertebrae.In the coronal aspect,the changes of subjective symptoms before and after treatment were significantly correlated with the changes of dynamic imaging,and the correlation between the subjective indicators on the coronal aspect and dynamic imaging parameters was higher.The dynamic imaging model of lumbar instability was used to evaluate the prognosis of the treatment effect,but it had no effect on the rotation and displacement of the sagittal position of the vertebral body.In the coronal plane evaluation,the prognosis evaluation of the model is basically consistent with the clinical efficacy evaluation.Conclusion1.Manipulation has a good effect in the treatment of lumbar instability.2.Manipulation can relieve abnormal intervertebral movement in patients with lumbar instability.Improve the spinal stability,the use of quantitative fluoroscopy to establish QF simulation model of the lumbar spine can change of motion between the vertebral body dynamic capture,can accurately find movement dysfunction in patients with the problem,to reveal the pathogenesis of lumbar instability syndrome and spinal massage action mechanism for the treatment of unstable lumbar disease are important role,there is great application prospect in the spine related discipline.