仰卧前屈拔伸牵引治疗伴退变性脊髓压迫神经根型颈椎病的效果及安全性评价

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Abstract Objective To investigate the efficacy and safety of supine flexion traction in the treatment of cervical spondylotic radicular spondylosis with degenerative spinal cord compression. Methods From September 2014 to December 2015, 21 middle-aged and elderly patients with degenerative spinal cord compression type cervical spondylotic radicular in Guangdong Province Hospital of Traditional Chinese Medicine were selected as research objects. Supine flexion traction was used as conservative treatment. The visual analogue scale score (VAS) and neck dysfunction index (NDI) were used to evaluate the efficacy. The changes of spinal nerve function were detected with somatosensory evoked potential (CSEP), and the changes of the sagittal diameter of the spinal canal were investigated with the combination of multi position magnetic resonance (MRI) technique. All patients were followed up for 1 year after treatment. Results All 21 patients completed the multiple body position MRI, CSEP examination and 10 days of treatment, and they were followed up for 1 years after treatment, the effective follow-up rate was 100%. One patient was turned into surgical treatment during the follow-up period due to the aggravation of the upper limb numbness. The VAS score of after 2, 4, 6, 8 d and 10 d of treatment and 1 year follow up of the remaining 20 patients were lower than those of before treatment (P < 0.01). The NDI score of after10 days of treatment and 1 year follow up were also significantly lower than those of before treatment (P < 0.01). The evoked potential latency of CSEP and amplitude between in the flexion traction and normal position were compared, the difference were not statistically significant (P > 0.05). The valid sagittal diameter of the spinal canal of flexion position was significantly greater than that of neutral position (t=3.56, P=0.00), while neutral position was significantly greater than that of the posterior extension (t=4.22, P=0.00). Conclusion Supine flexion traction is effective and safe for cervical spondylotic radicular spondylosis with degenerative spinal cord compression. But due to small sample size and short follow-up time, a larger sample size and longer follow-up observation are still needed. The study of indications and contraindications is also needed to improve the curative effect and prognosis. In addition, should further study the relationship between the spinal cord compression and the changes of spinal cord function and the prognosis of the disease so as to provide the basis for the intervention of such diseases.

Key words： Cervical spondylotic radiculopathy Degenerative spinal cord compression Traction

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	XU Hongzhi LIN Dingkun▲ CHEN Bolai

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XU Hongzhi LIN Dingkun▲ CHEN Bolai. Evaluation of the efficacy and safety of supine flexion traction in the treatment of cervical spondylotic radicular spondylosis with degenerative spinal cord compression[J]. 中国医药导报, 2018, 15(12): 53-57.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I12/53

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