坐位腰椎旋扳手法操作中腰椎的骨性耦合运动特征研究OA

Objective:To analyze the characteristics of bony coupled motion of lumbar spine during seated lumbar rotatory manipula-tion.Methods:A 27-year-old healthy male volunteer was selected to undergo lumbar CT scans in the neutral position and at the endpoint of seated lumbar rotatory manipulation,respectively(taking the left-side manipulation as an example).A three-dimensional model of the entire lumbar bone structure was established based on CT scan data.The lateral bending angle,flexion-extension angle,and rotation angle of each lumbar segment relative to S,,and the rotation angle of the upper lumbar segment relative to the lower lumbar segment were measured,and the change values of each angle(the difference between the measured value at the manipulation endpoint and the measured value in the neu-tral position)were calculated.Results:①Measurement results of the position of each lumbar segment relative to S1.In the coronal plane,each lumbar segment showed mild right bending relative to S1 in the neutral position;at the manipulation endpoint,the lateral bending angle of each lumbar segment relative to S1 increased,showing a leftward shift.In the sagittal plane,lumbar segments shifted forward as a whole relative to S,in the neutral position,presenting a mild lordotic curve;at the manipulation endpoint,the lordotic flexion-extension angle of L,-L3 segments relative to S1 increased slightly,while L4 and L5 shifted backward.In the horizontal plane,each lumbar segment showed mild right rotation relative to S,in the neutral position;at the manipulation endpoint,the rotation angle of each lumbar segment relative to S,increased,all rotating to the left,but the rotation angle and the change value of the rotation angle gradually decreased from top to bottom.②Measurement results of the rotation angle of the upper lumbar segment relative to the lower segment.During the manipulation,the upper lumbar segment relative to the lower segment all rotated to the left.Relative to L5,the change values of the rotation angle of L,-L4 de-creased from top to bottom.When the reference point moved upward,except that the change value of the rotation angle of L3 relative to L4 was greater than that relative to L5,and the change value of the rotation angle of L,relative to L2 was greater than that relative to L3,the change values of the rotation angle of the upper segment relative to the lower segment also gradually decreased.Conclusion:During the seated lumbar rotatory manipulation,the upper lumbar spine(L1-L3)is the main area responding to the manipulation,with ipsilateral later-al bending coupling and lordosis coupling;the lower lumbar spine(L4,L5)mainly plays a role in maintaining stability,with ipsilateral lateral bending coupling and extension coupling;there is rotational coupling in the lumbar spine as a whole and between each lumbar segment.