The Dependablity Investigation Of Bony Construction Parameters In Chronic Low Back Pain

Objectives: To measure and compare texture parameters of lumbar vertebra inChronic low back pain(CLBP) and to analyze dependability between changes oftexture parameters of lumbar vertebra and CLBP, to approach practical clinical valuein different parameters of lumbar vertebra. To compare difference of textureparameters of lumbar vertebra in different ages and approach practical clinical valuein diagnosis of CLBP and Lower lumbar intervertebral disc herniation(LLDH) byX-ray. To approach practical clinical value of functional exercise of abdominalmuscle in lumbar intervertebral disc herniation(LDH).Materials and Methodsdata and case 123 patients of CLBP and 82 patients of LDH come from traditionalChinese medicine orthopedics and vertebra orthopedics of Nanfang hospital. 28Non-CLBP cases come from medical examination center of Nanfang hospital. 46LDH cases come from HeNan hospital of Chinese army police force.Internalize standard To accord with standard of CLBP. Unremitting andintermittent pain from low back, haunch to extremitas inferior, it last more than threemonths. The LDH means there are appearance of intervertebral disk hernia throughclinical medical examination and to confirmed by CT scan. The post-treatment casesof LDH to bring into clinical trial must exceed twenty years old and less than sixtyyears old. In addition the modus operandi should be ex of nucleus gelatinosus fromback windowing and the person should go with us to follow up.Exclusion standard The CLBP from fracture of lumbar vertebra, dearticulation; spinal tuberculosis,tumor,infective inflammation and other internal medicial disease.Lumbar intervertebral disc herniation except L_4.5 and L₅S₁ intervertebral discherniation.Parameters and measures 1. Measuring some parameters of lumbar vertebra onX-ray lateral projection as follow: angle of tilted sacrum(or lumbosaeral angle);lumbar vertebrae curvature(measured by Seze's method); angle of lumbar vertebrae;anterior arch angle of juncturae lumbosacralis; included angle of juncturaelumbosacralis; exponent of L₅ vertebral body; height of L₅S₁'s discusintervertebralis; angle of juncturae lumbosacralis and angle of lumbosacral disc.2. Measuring angle of tilted sacrum(or lumbosacral angle); lumbar vertebraecurvature(measured by Seze's method); angle of lumbar vertebrae curvature; heightof L₅ vertebral body; height of L₅S₁'s discus intervertebralis; angle of lumbarvertebrae articulationes zygapophysiales on X-ray lateral projection and CT film.3. The curative effect evaluation about 46 post-treatment cases of LDH according toMacnab method. Anteflexed functional evaluation of lumbar vertebrae according todistance which from middle finger tip to floor when the case stand up and bend hislumbar vertebrae.Cases and Grouping 1. According to information of 123 CLBP cases, dividatur itinto CLBP group,LDH group and normal control group; According to ages, divid itinto≤30 group,31-40 group,41-50 group,51-60 group and＞60group; Accordingto sex differences,divide it into male group and female group.2. 82 patients of were divided into L4,5 hernia group, L₅S₁ hernia group and L₅S₁bulge group.3. 46 patients of LDH were randomly divided into exercising abdominal musclegroup and normal control group.Statistical methods Compared with multitude means on LSD of One-wayANOVA, and Compared with two means on t test of independent sampler.Confidence interval was 95ï¼…, P＜0.05 had significant difference.Results: 1. There was not significant difference in angle of tilted sacrum,lumbar vertebrae curvatur,angle of lumbar vertebrae curvature and height of L₅S₁'s discusintervertebralis on each ages. There was significant difference in included angle ofjuncturae lumbosacralis between 51-60 age group and≤30 age group(P=0.029＜0.05).There was significant difference in each group except 41-50 age group on includedangle of juncturae lumbosacralis, 31-40 age group compares with≤30 age group:P=0.005＜0.01, 51-60 group compare with≤30 age group: P=0.039＜0.05,＞60 agegroup compares with≤30 age group: P=0.008＜0.01; There was significant differencein≤30 age group comparing with other groups except 51-60 age group on anteriorarch angle of juncturae lumbosacralis. (31-40 age group vs≤30 age group:P=0.036＜0.05; 41-50 age group vs≤30 age group: P=0.005＜0.01;＞60 age group vs30 age group: P=0.028＜0.05)There was significant difference in anterior arch angleof juncturae lumbosacralis between 51-60 age group and 41-50 age group(P=0.018＜0.05). In exponent of L5 vertebral body,＞60 age group vs≤30 agegroup:P=0.016＜0.05;＞60 age group vs 31-40 age group: P=0.021＜0.05;＞60 agegroup vs 51-60 age group: P=0.014＜0.05; There was significant difference in angle oflumbosacral disc between≤30 age group and 51-60 age group(P=0.029＜0.05). Thereonly was significant difference in included angle of juncturae lumbosacralis and angleof juncturae lumbosacralis between male group and female group(P=0.007＜0.01,P=0.004＜0.01). There was significant difference in angle of lumbosacral disc andheight of L₅S₁'s discus intervertebralis between lumbar intervertebral disc herniationgroup and CLBP group.(P=0.049＜0.05, P=0.007＜0.01). In addition, the significantdifference in angle ofjuncturae lumbosacralis (P=0.000＜0.01),anterior arch angleof juncturae lumbosacralis (P=0.022＜0.05),angle of tilted sacrum (P=0.000＜0.01),lumbar vertebrae curvature (P=0.000＜0.01),angle of lumbar vertebrae curvature(P=0.010＜0.05) and exponent of L5 vertebral body(P=0.000＜0.01)between CLBPgroup and non-CLBP group.2. The texture parameters of LLDH indicates the significant difference in lumbosacralangle lumbar vertebrae curvature and height of L₅S₁ intervertebral disc comparingcontrol group with L₅S₁ intervertebral disc herniation group,L₅S₁ bulge group, L_4,5intervertebral disc herniation group. The significant difference in height of L₅S₁intervertebral disc among L₅S₁ intervertebral disc herniation group,L₅S₁ bulgegroup,L_4,5 intervertebral disc herniation group. There was significant in height of L₅vertebral body between L₅S₁ intervertebral disc herniation group and L_4,5intervertebral disc herniation group. There was significant difference in lumbarvertebrae curvature between L₅S₁ intervertebral disc herniation group and L₅S₁ bulgegroup. The same consequence in ratio of disc and vertebra among L₅S₁ intervertebraldisc herniation group,L_4,5 intervertebral disc herniation group and control group.L₅S₁ bulge group compared with L_4,5 intervertebral disc herniation group (P＜0.05).There was not significant difference in facet joint at L₅S₁ level among four groups3. It also had significant difference in lumbar vertebrae Flexed function betweenabdominal muscle functional exercise grouop and common functional exercise group.Conclusion: 1. Lumbosacral angle and anterior arch angle of lumbosacral differentages of CLBP patients had significant difference, compared with the normalgroup,except the lumbosacral angle, lumbosacral disc angle and height of L₅S₁ disc,the others were significant differences.2. In different sex lumbar vertebra bone structure datas of CLBP patients, lumbosacralarticulation and lumbosacral angle were significant differences.3. Low lumbar intervertebral disk hernia had significant changes in lumbosacral angle,lumbar vertebra curvature and intervertebral space, and L₅S₁ was easier than L_4,5 inthese structure changes.4. Exercising abdominal muscles can not only establish a new banlance of lumbarvertebra,but improve the inflexion function.