Acupotome Cutting Yellow Ligament Treated Yellow Ligament Hypertrophic Lumbar Cone Tube Stenosis Disease Anatomical Basis And Clinical Application

Objective Through the study of anatomy, lumbar yellow ligament to design a conform to the anatomy, the operation is simple, small damage, satisfactory curative effect of needle knife in the treatment of hypertrophic yellow ligament lumbar spinal stenosis disease.Methods Observation and measurement of 6, 12 adult lumbar spine specimens yellow ligament of the specimen, according to the normal anatomical methods were observed and measured the lumbar spine specimen of yellow ligament structure and load-point shape, line direction;The thickness of the lumbar spine yellow ligament;Lumbar vertebral plate length, lamina Angle and vertebral plate edge to the distance from the same intervertebral disc edge;Lumbar vertebral plate gap.And from the perspective of the human body mechanics research yellow ligament treated yellow ligament thickening type lumbar spinal stenosis disease etiology of pathological mechanism, on the basis of the anatomical structures designed needle knife cutting yellow ligament treated yellow ligament thickening type lumbar spinal stenosis overall release the "back" glyph of needle knife.At the same time, collection of hubei university of Chinese medicine example, needle knife of hospital in October 2013 to October 2015, 21 cases of hypertrophic yellow ligament treated patients with lumbar spinal stenosis, according to the operation treatment.Results Anatomic study results: lumbar yellow is a yellow ligament fiber connective tissue, walking between adjacent vertebral plate, is divided into two half, two layer, deep and shallow yellow ligament occupy the vertebral canal dorsal about 3/4 area;The waist yellow ligament change with segmental changes occur, embodied in its thickness presented top-down gradually thickening;Lumbar vertebral plate longitudinal length from the L1 ~ L5 vertebral plate length became smaller, L1 differ with L5 vertebral plate length about 6 mm.Vertebral plate length is different in L1 ~ L3;The lumbar vertebral plate Angle is relatively close, the average 14.92 °, L1 vertebral plate Angle larger, 15.57 °±5.62 °, and the Angle are greatly influenced by individual factors;Vertebral plate edge to the same edge on the distance from L1 to L5 vertebral bodies, in turn, increases, left and right side has no obvious difference;Of T12 ~ L1 to L5~ S1 gap width increases gradually, the largest, growing gap between the L5~ S1 than L4~ 5 increase about 2 mm long;Vertebral plate clearance height of T12~ L1 to L5~ S1 showed a trend of gradual increase in clearance height, and on both sides of the central height is greater than the height, has no obvious difference between left and right side height, in the middle width on both sides of narrow ovoid.Clinical research results: postoperative visit for a year, 21 cases of patients with lumbar pain relief, intermittent claudication recovery is obvious.Function evaluation, the results of 17 cases, good in 2 cases, 2 cases, 0 cases, fine rate was 90.4%.Conclusion According to the anatomic study applied to clinical, secco admitted to me lumbar cone tube stenosis in patients with hypertrophic yellow ligament "back" glyph needle knife overall solution treatment, and follow-up, evaluation function, we think: hypertrophic yellow ligament, lumbar spinal stenosis in the underlying cause is the waist of the anatomy of the bowstring mechanics system caused by the force balance disorder.And yellow ligament serves as the waist of the anatomy of the bowstring mechanics system static string, when lumbar bowstring mechanics anatomical system force balance disorders, yellow ligament stress anomaly, make the normal structure of yellow ligament damage, and long-term chronic damage accumulation and reactive repair process, will eventually lead to yellow ligament hypertrophy, appear even yellow ligament calcification.Lead to epidural and nerve root compression, triggered a series of clinical symptoms.Needle knife for the treatment of hypertrophic yellow ligament lumbar spinal stenosis mechanism to release the waist soft tissue, especially the yellow ligament of adhesion and scar, abnormal stress, relieve the waist soft tissue by the abnormal state of mechanics into the human body can be compensated within, through the body's powerful self recovery and adjustment potential, restore the waist of the anatomy of the bowstring mechanics system force balance, thus healing the disease.Needle knife treatment of the disease is built on a sound theoretical foundation and precise anatomic structure, and in the preoperative, intraoperative and postoperative have strict requirements.Therefore, needle knife treatment of the disease is safe.Treatment of the disease and needle knife is convenient and quick operation.Little trauma and quick recovery.The advantages of low cost, is easily accepted by patients.