多层螺旋CT三维重建评价“三维平衡正脊手法”治疗神经根型颈椎病疗效的临床研究

发布时间：2018-03-08 07:36

本文选题：颈椎病　切入点：神经根型　出处：《济南大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的运用多层螺旋CT扫描技术,通过三维重建分析神经根型颈椎病患者“三维定点平衡正脊”治疗前后C4~C7段力学模型变化,评价三维平衡正脊手法治疗神经根型颈椎病的疗效,探讨其作用机理。方法30例符合神经根型颈椎病诊断标准的患者,采用三维平衡正脊手法治疗前后分别行颈椎螺旋CT扫描,并三维重建颈椎立体模型。行三维平衡正脊手法治疗一疗程后,分析螺旋CT观察指标的变化,包括:颈椎生理曲度、颈椎棘突与中线的关系、椎间孔、颈椎间盘的变化情况,并结合症状、体征进行分析。结果神经根型颈椎病的三维平衡正脊手法治疗能有效减轻患者临床症状,手法治疗后观察到的影像学指标:颈椎生理曲度、颈椎棘突与中线的关系及椎间孔改变均较治疗前有明显变化,统计学分析有意义(P0.05)。结论1、三维平衡正脊手法治疗神经根型颈椎病疗效肯定。2、三维平衡正脊手法对神经根型颈椎病的治疗安全、有效,其机制可能是调整了颈椎生物力学平衡,放松紧张的肌肉,改善局部血液循环,改善小关节的紊乱,改善神经与突出椎间盘的相对位置关系,相对扩大椎间孔与椎间隙的距离,松解神经根的黏连,最终改善了患者的临床症状。3、颈椎螺旋CT扫描并三维立体重建较清楚的显示了手法治疗前后神经根型颈椎病的影像学变化:生理曲度的改善、棘突位置的恢复、椎间孔的扩大等等。颈椎螺旋CT扫描并三维立体重建在评价神经根型颈椎病的治疗中具有广泛应用前景。
[Abstract]:Objective to evaluate the effect of three-dimensional balanced spinal manipulation on cervical spondylosis of nerve root type by using multi-slice spiral CT scanning technique, and to analyze the changes of C _ 4 C _ 7 segment mechanical model before and after treatment of "three dimensional fixed-point balanced straight ridge" in patients with cervical spondylopathy of nerve root type. Methods Thirty patients with cervical spondylopathy of nerve root type were examined by spiral CT before and after treatment. Three dimensional reconstruction of cervical vertebrae model. After a course of treatment, the changes of spiral CT were analyzed, including the physiological curvature of cervical spine, the relationship between cervical spine spinous process and midline, the changes of intervertebral foramen and cervical intervertebral disc. Results Three-dimensional balanced ridge manipulation treatment of cervical spondylopathy of nerve root type can effectively alleviate the clinical symptoms of the patients. The imaging index observed after manipulation treatment is the physiological curvature of cervical spine. The relationship between spinous process and midline of cervical spine and the change of intervertebral foramen were significantly different from those before treatment. Conclusion 1. Three-dimensional balanced positive ridge manipulation is effective and safe in the treatment of radicular cervical spondylosis, and its mechanism may be to adjust the biomechanical balance of cervical vertebra. Relax tense muscles, improve local blood circulation, improve the disorder of facet joints, improve the relative position of nerve and herniated intervertebral disc, expand the distance between intervertebral foramen and intervertebral space, release the adhesion of nerve root, Finally, the clinical symptoms of the patients were improved. The spiral CT scan and three-dimensional reconstruction of the cervical spine clearly showed the imaging changes of cervical spondylosis of nerve root type before and after manual treatment: the improvement of physiological curvature, the restoration of the position of spinous process, The enlargement of intervertebral foramen and so on. The spiral CT scan and three-dimensional reconstruction of cervical vertebrae have a wide application prospect in evaluating the treatment of cervical spondylopathy of nerve root type.
【学位授予单位】：济南大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R681.5

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