| Objective: To evaluate the impact on spine mophology by comparing before and after L4/5 lumbar disc herniation treated with Rotatory Manipulation.To elucidate the mechanism of Manipulation Therapy,which can provide new idea and reliable evidence for the treatment methods.Methods: Selected 30 patients diagnosed as Hu you gu partition " I layer 1-2district,a prominent" field type of L4/5 lumbar disc herniation.All of the patients were in the first affiliated hospital of guangxi university of chinese medicine affiliated “ren ai”branch orthopedics outpatient.Patients who received separate cervical vertebra ? thoracic ? lumbar and pelvic digital radiographs at the same time when keeping his or her position immovable between April 2015 and December 2015 were enrolled in the study.The image information in jpg form input computer,to save for the unit with the every patient.Adobe Photoshop CS6 was used to seamless splice each part of spinal image into full length spinal image under the critique and guidance of radiologist to make sure each of the full length image was clear to see and without anatomical and mophorlogy distortion.30 successful seamless splicing spinal full length images were saved and imported into PACS(Picture Archiving and Communication Systems),PACS was used to measure the most bending vertebral body and the trunk imbalance angles.All the data were written into the excel table and to calculate the most shift vertebral body in related segments and the trunk imbalance angles.Each part of patients' spinal image was seamless sliced again into full length spinal image after 5 times of Rotatory Manipulation treatment.To calculate anatomical and morphology changes of spine and the change of trunk imbalance angles by comparison of before and after treatment.Simultaneously,the alterations in scores of Japanese Orthopaedic Association(JOA)and Visual Analogue Scale(VAS)were recorded.Results:1.Symptomatology and the quantitative scores of the cases treated with rotatory manipulative therapy were improved obviously,and there were statistical significances in difference(P < 0.01).2.After measurement,the cervical segment offset vertebral bodies were mainly distributed in C6-C3 vertebral body.The C3 migration was 22(73%),C4 accounted for 4(13%),C5 accounted for 2(7%),C6 in 2 cases(7%);Thoracic segment offset vertebral body is mainly distributed in T11 T3 vertebral body,among them T6,T9 each accounted for 2 cases(7%),T7,T10,T12 each accounted for 3 cases(10%),T3,T4,T11 each accounted for 4 cases(13%),T8 accounted for 5cases(17%);Lumbar vertebral segment was distributed in the L1-L5 vertebral body,L5 accounted for 4 cases(13%),L2 accounted for 5 cases(17%),L3,L4 each accounted for 6 cases(20%),L1 accounted for 9 cases(30%).3.The changes of the cervical and thoracic offset as well as the trunk imbalance angles before and after the rotation reduction method all have the statistical significances(P < 0.05),and the change of the lumbar migration distance was not significant(P > 0.05).4.The improvement degree of trunk imbalance angle had significant positive correlation with JOA score and VAS score.Conclusions:1.The rotation reduction method could effectively alleviate the clinical symptoms and signs of the patients with lumbar disc herniation as well as improve their life qualities.2.It can be approved that there are overall spinal biomechanical imbalances of different degrees among the patients with lumbar disc herniation.3.Rotatory Manipulation can treat the lumbar disc herniation,mean while,giving dual affention to the adjustment of abnormal structure of the thoracic vertebra and the cervical vertebra untill all tend to be balanced. |
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