| Objective: Adopt Finite Element Simulation of back muscle exercise, angle traction incomputer Simulation by tutor experiments confirmed,Back muscle exercise dorsiflexionbit more in line with the requirements of the biomechanics than flexion,But tutorconsider dorsiflexion angle is not the bigger the better.This study was designed bysimulating lumbar disc bulging subjects, the difference in angle conditions conduct backmuscle exercise, contrast dorsiflexion angle changes lumbar disc moisture contentdiameter of spinal and dural sac diameter changes before and after, range patientspersonalized training methods to provide theoretical guidance for low back pain, backmuscle exercise more precise.Methods:①Select spine and low back pain neck section of Henan-luoyang orthopedic-traumatological hospital patient,which L4/5disc bulge10, L5/S1disc bulge10.②Afterpatients with normal MRI determine the Lumbar disc bulging, place upholsteredsimulation low back muscle exercise in the rear lumbar, upholstered size of the two, tosimulate dorsiflexion angle10°and20°.③The use of nuclear magnetic resonancediffusion-weighted imaging (DWI) scan routine MRI scans obtained image.④Withsoftware tools measure specific data, draw the angle of lumbar intervertebral discisotropic apparent diffusion coefficient (ADC), T2weighted unenhanced bitanteroposterior diameter of spinal and T2weighted sagittal dural sac diameter.Results:①When the lumbar supine position, dorsiflexion10°or20°，L4/5disc ADCvalues were（1226.03±276.02）×10-3mm2/sec、（1069.91±299.06）×10-3mm2/sec、（983.80±273.67）×10-3mm2/sec， The difference was not statistically significant（F=1.881，P=0.172）；The anteroposterior diameter of spinal（1.08±0.18）cm、（1.17±0.18）cm、（0.94±0.21）cm，The difference was statistically significant (F=3.509,P=0.044); Further pairwise comparison,10°and20°before and after spinal diametercompared，The difference was statistically significant（P=0.014）；0°and10°,20° before and after spinal diameter, the difference was not statistically significant (F=0.312,P=0.122);The dural between diameter respectively（9.31±2.22）mm、（9.80±2.27）mm、（7.73±2.03）mm，The difference was not statistically significant（F=2.468，P=0.104）。②The lumbar supine position, dorsiflexion10°,20°or when the L5/S1intervertebraldisc ADC value were（1307.22±205.20）×10-3mm2/sec、（1097.16±200.59）×10-3mm2/sec、（953.33±200.66）×10-3mm2/sec，The difference was statistically significant（F=7.750，P=0.002）；Further pairwise comparisons,0°and10°,20°disc ADC value,the difference was statistically significant (F=0.028, P=0.001),10°and20°disc ADCvalue, the difference was not statistically significant (P=0.123);Anteroposterior diameterof spinal (1.51±0.29) cm,(1.64±0.29) cm,(1.40±0.31) cm, the difference was notstatistically significant (F=1.730, P=0.196);Dural sac between the diameter, respectively(14.54±3.31) mm,(14.94±3.29) mm,(12.98±3.31) mm, the difference was notstatistically significant (F=0.979, P=0.389).Conclusion:①With the changes in the lumbar dorsiflexion angle, lumbar intervertebraldisc by squeezing the extent changes in disc water content will change accordingly.L4/5disc prolapse patients, this change is not obvious;L5/S1bulging disc patients, lumbardorsiflexion causes reduced disc water, but no significant difference in dorsiflexion angleon the moisture content of the disc.②L4/5disc prolapse patients with lumbardorsiflexion angle is too large can lead to L4/5segments of the spinal canal anteroposteriordiameter smaller, increasing the risk of cauda equina compression chance, the back muscleexercise lumbar back the extension angle should not be too large；L5/S1bulging discpatients, lumbar dorsiflexion angle on the the L5/S1segments of the spinal canalanteroposterior diameter has little effect, back muscle exercise increase the lumbardorsiflexion angle, without the danger of the cauda equina compression.③lumbardorsiflexion angle segment L4/5and L5/S1segments of the dural sac diameter. |
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