CAJ | 학술논문

[目的]为杠杆定位手法的作用机理与临床应用提供实验学依据。[方法]应用模拟手法的生物力学建模，当力的加载时用CT对健康志愿者的腰椎4-5进行实时扫描，观察三种体位的腰椎间盘形态与密度的变化。[结果]平躺位、后伸位、加力后伸位分别实时测试取腰椎4-5最中间层数据比较，发现后伸加力位的腰椎间盘纵、横向距离均变小，即椎间盘的横截面减小；腰椎间盘后缘、左、右缘密度均变大，中间密度均变小，即加力后伸体位时椎间盘内髓核向前发生位移。[结论]杠杆定位手法对正常的腰椎间盘应力应变发生明显的影响，在手法载荷过程中髓核的静水压下降，负压增加，椎间盘内髓核发生向前位移，髓核内压保持较低压力，说明杠杆定位手法安全而有效。
[목적]위강간정위수법적작용궤리여림상응용제공실험학의거。[방법]응용모의수법적생물역학건모，당력적가재시용CT대건강지원자적요추4-5진행실시소묘，관찰삼충체위적요추간반형태여밀도적변화。[결과]평당위、후신위、가력후신위분별실시측시취요추4-5최중간층수거비교，발현후신가력위적요추간반종、횡향거리균변소，즉추간반적횡절면감소；요추간반후연、좌、우연밀도균변대，중간밀도균변소，즉가력후신체위시추간반내수핵향전발생위이。[결론]강간정위수법대정상적요추간반응력응변발생명현적영향，재수법재하과정중수핵적정수압하강，부압증가，추간반내수핵발생향전위이，수핵내압보지교저압력，설명강간정위수법안전이유효。
[Purpose] To provide experimental evidence for mechanism of action and clinical application of the lever positioning manipulation. [Methods] Biomechanical modeling with simulation manipulation was applied. In order to observe the changes in morphology and density of the lumbar intervertebral disc of three orthostatic, real-time scanning focusing to 4~5 lumbar of healthy volunteers with CT was engaged when loading force. [Result] From the comparison of real-time data from middle layer between 4~5 lumbar at three different positions(lying down, extension and afterburning extension), we found that vertical and horizontal distance between 4~5 lumbers got smal er at the afterburning extension position(p value was less than 0.05), i.e. the cross-section of the disc was reduced; and that the density of back, left and right edges of lumbar discs raised, and core density got smal er simultaneously, indicating that inside the disc nucleus pulposus was displaced forward at afterburning extending position. [Conclusion] The lever positioning manipulation affected the normal stress-strain of lumbar intervertebral disc significantly. During the manipulation loading process, the hydrostatic pressure of the nucleoid dropped and negative pressure rose. Intradiscal nucleoid displaced forward, and a low pressure maintained inside the nucleoid. It il ustrated that lever posi-tioning manipulation was safe and effective.