The Study Of Effects Of The Supine Oblique Traction On The Lumbar Horizontal Curvature,lumbosacral Angle And Load Bearing Line In Patients With Unilateral L4/5 LDH

Objective: On the basis of massage and tendon therapy,then we used the supine oblique traction and analysised the therapeutic effect of this techniques to patients with the unilateral L4/5 lumbar disc herniation.After that,the changes of lumbar curvature,lumbosacral horizontal angle and load bearing line before and after treatment observed.In the end,we can explore the mechanism and effects of the supine oblique traction for LDH from the aspect of biomechanics and clinical norms in order to lay a strong theoretical foundation for promoting the treatment.Methods: Sixty patients with unilateral L4/5 lumbar disc herniation were numbered in accordance with the order of medical treatment from one to sixty.Then these patients were divided into treatment group and control group.The treatment group was treated with massage and tendon therapy combined with the supine oblique traction.The control group was treated with traditional massage and tendon therapy.The two groups of patients were treated 2 times a week,the 10 time for the 1 course of treatment.All the patients were taken conventional lateral lumbar X-ray before and after treatment.Meanwhile JOA score,Oswestry Disability Index and VAS score were used to score the efficacy.The statistical changes of indexes wereanalyzed through correlation analysis and statistical analysis by SPSS19.0statistical software.The normal distribution of measurement data is expressed as mean + standard deviation(x ±s);the Independent-Samples T Test was used to the comparison of two sets of data.The data of same group before and after treatment was compared with the Paired-Samples T Test.The enumeration data were tested by chi-square.The Pearson correlation test is used for correlation analysis.All the test were two-sided test,and were found to be statistically significant if P<0.05.Results: 1.Comparison of clincal efficacy: the effective rate of the treatment group and the control group had significant difference(P<0.05),and the treatment group was significantly higher than the control group.2.After treatment,the JOA score,Oswestry Disability Index and VAS score of patients in the treatment group and the control group had significantly improved and the difference was statically significant(P<0.05);the treatment group was significantly higher than the control group.3.Before and after treatment,the lumbar curvature,lumbosacral horizontal angle and load bearing line before and after treatment in the treatment group or the control group had changed.The difference was statically significant(P<0.05).The changes of the lumbar curvature and lumbosacral horizontal angle in the treatment group was significantly higher than the control group(P<0.05).4.Correlation analysis of lumbar curvature,lumbosacral horizontal angle and load bearing line:(1)The lumbar curvature and lumbosacral horizontal angle has a significant positive correlation(R=0.666,P<0.05).The result show that thehigher the value of lumbar curvature changes,changes in lumbosacral horizontal angle corresponding value is higher.(2)The lumbar curvature and load bearing line has a significant negative correlation(R=-0.701,P<0.05).The result show that the larger the value of lumbar curvature changes,the smaller changes in load bearing line corresponding value.(3)The lumbosacral horizontal angle and load bearing line has a significant negative correlation(R=-0.849,P<0.05).The result show that the higher the value of lumbosacral horizontal angle,the smaller changes in load bearing line corresponding value.Conclusion: The treatment of L4/5 lumbar disc herniation used by the supine oblique traction combined with massage and tendon therapy has better curative effect,and is superior to simple massage and tendon therapy.The the supine oblique traction can improve the patient's lumbar curvature,lumbosacral angle and load bearing line,the changes of three sets of values are correlated.When the lumbar curvature increases,the lumbosacral angle becomes larger.But the numerical changes of the load bearing line decrease.Although the value of load bearing line is decreasing because of the measurement method,the situation of the straight lumbar curvature in patients is improved.So the internal structure of the lumbar spine tend to be balanced.Therefore,the supine oblique traction combined with massage and tendon therapy can restore the patient's lumbar curvature,improve the lumbosacral angle and correct the load bearing line's position relative to the sacrum.All the changes can restore a certain mechanical balance of the lumbar spine and thus play a therapeutic effect.