The Study Of The Relationship Between The Clinical Effect Of Manipulation And The Radiographic Changes In Treating For Lumbar Instability Based On Quantitative Fluoroscopy

Objectives:(1)Studying The vertebral tracking algorithm by surveying and calcuating radiographic parameters.(2)studying the clinical effect of manipulation in treating for lumbar instability by clinical observation and follow-up visit and radiographic changes between before and after treatment.(3)discuss the relationship between the clinical effect of manipulation and the radiographic changes in treating for lumbar instability.Methods:We enroll 15 patients of the department of orthopaedics of Chinese traditional medicine hospital.Wuxi in our research according to the selection routine from January 2015 to December 2016.Patients perform quantitative fluoroscopy examination and we record the pain scores(lumbar back pain JOA score and Oswestry dability index)and the imaging data before and after manipulation.We follow up the patients for 6 months.We prove The vertebral tracking algorithm by surveying and calcuating radiographic parameters and then we get right imaging data.We use statistical method to compare the pain Score and image data changes before manipulation with the one after manipulation.We evaluate the clinical effect of manipulation in treating for lumbar instability.We perform correlation analysis with the pain scores and maging changes in all patients before and after manipulation to determine whether there is a correlation between them.Results:All subjects who met the criteria have completed the treatment and quantitative fluoroscopy,adverse symptoms have not happened during treatment,all the symptoms of patients were relieved to varying degrees.JOA score before treatment is 17.67±2.289,JOA on the day after treatment score is 23.53±2.232,JOA score 6 months after treatment is 23.47±1.598.ODI score before treatment is 67.2±3.783,ODI score on the day after treatment 29.6±3.621,ODI score 6 months after treatment is 29.93±3.035.T test show that JOA score and ODI score have difference between preoperative and postoperative(P<0.05),indicating that the pain of lumbar instability have been alleviated after manipulation.There is no significant difference between the JOA score and the ODI score(P>0.05)postoperative and postoperative 6 months,indicating that there is no significant change in pain after manipulation.AZ,BZ,CZ,RX,RX2 of the vertebral body perform t test Before treatment,the treatment of the day after treatment,the changes of displacement and rotation of sagittal and coronal vertebral body have difference between before and after treatment have statistical signaficance(p<0.05),indicating that the displacement and rotation of the sagittal and coronal vertebral body after 6 months follow-up has not been significantly changed(p>0.05).The improvement rate of JOA score and the improvement rate of ODI score are compared with the rate of change of AZ after treatment,BZ change rate,CZ change rate,RX change rate and RX2 change rate respectively.The results show that groups have statistical signaficance(p<0.05),indicating that function improvement have correlation with radiographic changes.Conclusion:We find manipulation in treating for lumbar instability has effect by observation of 15 cases of lumbar instability before and after treatment and imaging analysis.The KLT tracking algorithm is more effective in vertebral body tracking by the algorithm experiment.The displacement and angle of the vertebral body in the sagittal plane and the coronal plane have changes after manipulation.The clinical effect of manipulation has correlation with the dynamic radiography and coronal plane.