The Preliminary Study Of Sagittal Imbalance In Patients With Lumbar Spinal Stenosis Before And After The Four-dimensional Orthopaedics Traction

ObjectiveThis study is to explore the the efficacy of the "four dimensional "traction in the treatment of degenerative lumbar spinal stenosis disease and apply the spinal pelvic equilibrium parameters to preliminary understanding of its mechanism, provide meaningful clinical evidence-based evidence for used the method of "four dimensional" traction in degenerative lumbar spinal stenosis.MethodsSelected110cases of orthopedic inpatients, who suitable for diagnostic criteria and inclusion criteria, exclusion criteria of degenerative lumbar spinal stenosis patients. All those patients were randomly divided into "four-dimensional" orthopaedics traction therapy group^pelvic traction control group. The treatment of two groups base on a basic treatment, add "four-dimensional" orthopaedics traction to experimental group, the control group add pelvic traction. before and after two weeks treatment, the whole spine radiographs was taken respectively, measure sagittal balance parameters of radiographic on lateral X-rays, including pelvic incidence angle (PI), sacral inclination angle (SS), pelvic tilt angle (PT), thoracic kyphosis (TK), lumbar lordosis (LL), sagittal balance ratio (SBR), and use ODI, JOA, VAS scales evaluated all patients before and after treatment three months later follow-up. Using SPSS18.0statistical analysis of all the data, analyze the relationship between the parameters, the correlation between changes in the OD、JOA、VAS scales before and after treatment with various parameters, the correlation between relif of symptoms and changes in radiographic parameters.ResultsAmong110subjects, nine experimenter quit for various reasons, ultimately101patients completed the study, the treatment group had50cases,51cases in the control group. The age, gender, disease duration, treatment, and distribution of TCM contrast in two groups had no significant difference (P>0.05), the two groups at equal baseline. Compare LL、PI、 SS、PT before and after treatment within the group, there is a statistically significant difference between them (p<0.05), PI、SS、LL were increased before and after treatment the TK had no difference (p>0.05). After treatment, the LL、SS、PT between groups had significant differences (p <0.05), the PI、TK had no difference (p>0.05). Comparing the difference before and after treatment, the LL, SS, PT had differences (p<0.05) between the two groups, and considered that the experiment group changes greater than the control group. The SBR changes of before and after treatment between two groups had no significant difference (P>0.05). The pairwise comparison of JOA, ODI scores in two groups before treatment,2weeks,3months after treatment had significant differences (p<0.001). And JOA, ODI scores between the two groups before treatment,3months after treatment had no significant difference, but the JOA, ODI scores had significant differences in two groups after two weeks treatment, and the experimental group was superior control group. Comparison of the VAS scores within group, before and after treatment the VAS scores had significant difference(P<0.001); between the two groups, there are differences after treatment of two weeks, can be considered that experimental group precede than the control group. In "four dimensional" orthopaedics traction group, PI and SS、LL were significantly correlated before and after treatment, SS and PT、LL were significant correlation before and after treatment; in pelvic traction group, PI and SS, PT, LL had significantly correlation before and after treatment, SS and LL were significantly correlated before and after treatment. In "four dimensional" orthopaedics traction group, PI and JOA, ODI and SS related before the therapy; ODI and PT, TK, LL, SS related after the threapy in " four dimensional " orthopaedics traction group. In control group, ODI were associated with the SS before and after treatmentConclusion Two kind of traction therapy for degenerative lumbar spinal stenosis are valid in the short-term effect, the "four dimensional" orthopaedics traction group is better than control therapy group, but the two long-term effect is quite. Pelvic-spinal sagittal parameters are closely related, and them have clear significance for treatment and prognosis in degenerative lumbar spinal stenosis. Pelvic spinal sagittal parameters and scales may have certain correlation.