The Influence Of Two Bone-setting Manipulations On The Lumbar-pelvic Related Parameters In Patients With LDH Accompanied By Pelvic Rotation

Objective: Lumbar disc herniation is a common clinical disease in orthopedics and traumatology,with a high incidence every year,which has a huge impact on today’s social productivity,the quality of life of the masses,and the physical and mental health.Compared with healthy people,the mechanical balance parameters of the lumbar spine and pelvis of LDH patients are specific,and the changes in related parameters are related to the biomechanical changes of the lumbar spine and pelvis,which can indirectly affect the progress,treatment and treatment of lumbar disc herniation.The prognosis of the disease has an impact.It is clinically found that some patients with LDH are often accompanied by pelvic rotation.From the perspective of biomechanics,such patients may also have specificity in the mechanical parameters of the lumbar spine and pelvis.For the conservative treatment of lumbar intervertebral disc herniation,TCM bone setting techniques have certain characteristics and advantages.In order to further explore the influence of traditional Chinese medicine bone setting techniques on the lumbar-pelvic parameters of LDH patients with pelvic rotation,as well as the evaluation of its curative effect,This study used the lumbar spine rotation reduction method combined with the modified pelvic traction lateral push method to treat LDH patients with pelvic rotation,and performed data on the changes in the lumbar-pelvic sagittal,coronal,and transverse plane parameters of such patients.Statistics,while analyzing the impact of related parameters,understand the curative effect of manipulation on patients.Methods: Thirty patients who met the inclusion criteria in the Orthopedics and Traumatology Clinic of the Renai Specialist Building of the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from April 2020 to April 2021 were selected as the treatment group.Lateral radiographs(including bilateral femoral heads)and plain pelvic radiographs;another 30 healthy volunteers were selected as the control group,and a lumbar anterior and lateral radiograph(including bilateral femoral heads)and pelvic radiographs were collected.Let patients cooperate in completing the personal information,JOA score and VAS score sheet and other information,as well as the collection of clinical symptoms,signs and other medical history.On the basis of conventional massage and relaxation,the treatment group used lumbar rotation reduction manipulation and modified pelvic traction lateral push manipulation to treat LDH patients with pelvic rotation,once a week,and 3 times as a course of treatment.The control group did not receive relevant manipulations and bonesetting treatments in this study,and there was no history of massage related treatments in the past.For the collected X-rays,the relevant parameters were measured according to the treatment group’s pre-treatment,post-treatment,and control group,including pelvic incidence angle(PI),pelvic tilt angle(PT),lumbar lordosis angle(LL),and sacral tilt Angle(SS),Cobb angle of the coronal plane of the lumbar spine,coronal pelvic inclination angle,left and right hip width ratio,etc.,and statistical analysis of the above data.Results: In the comparative study,there was no significant difference in age,gender and other data between the control group and the treatment group of 30 patients with lumbar intervertebral disc herniation(P>0.05);the treatment group in the comparative study had JOA scores before and after treatment.The difference in VAS scores was statistically significant(P<0.05);the difference in lumbar-pelvic parameters between the treatment group before and after treatment and the control group was compared,and the analysis results were obtained: comparing the treatment group before treatment and the control group,except for the PI value,Other differences in lumbar-pelvic parameters including SS,PT,LL,left and right iliac bone width ratio,coronal pelvic inclination angle,and lumbar Cobb angle were statistically significant(P<0.05);compare the treatment group with the control group after treatment,PT,LL,lumbar cobb angle and other parameters are statistically significant(P<0.05),PI,SS,left and right ilium width ratio,coronal pelvic inclination angle and other parameters are not statistically significant(P>0.05);The parameters of the lumbar spine and pelvis before and after treatment in the treatment group,SS,PT,LL,left and right iliac bone width ratio,coronal pelvic inclination and other parameters before and after treatment were significantly different in this type of LDH patients(P<0.05)),PI,Cobb angle of lumbar spine and other parameters were not statistically significant(P>0.05);the correlation analysis of the parameters of each group showed that: in the control group,PI was strongly correlated with SS and PT;PI was strongly correlated with SS and PT;There is no significant correlation between LL,left and right ilium width ratio,coronal pelvic tilt angle,and lumbar cobb angle;SS is weakly correlated with PT,SS is not significantly correlated with LL,left and right ilium width ratio,coronal pelvic tilt angle,and lumbar cobb angle PT has no significant correlation with LL,left and right ilium width ratio,coronal pelvic inclination angle,and lumbar cobb angle;LL is weakly correlated with coronal pelvic inclination angle,LL has no obvious correlation with left and right ilium width ratio and lumbar cobb angle;There is no significant correlation between the left and right ilium width ratio with the cobb angle of the lumbar spine and the cobb angle of the coronal pelvis;the coronal angle of the pelvis has no significant correlation with the cobb angle of the lumbar spine.In the pre-treatment group of patients with LDH with pelvic rotation: PI was strongly correlated with SS and PT;PI was weakly correlated with LL,and PI was not significantly correlated with left and right ilium width ratio,coronal pelvic tilt angle,and lumbar cobb angle;SS and PT are weakly correlated,SS and LL,left and right ilium width ratio,coronal pelvic tilt angle,and lumbar spine cobb angle are not significantly correlated;PT is weakly correlated with LL,left and right ilium width ratio,PT and coronal pelvic tilt angle,Lumbar spine cobb angle is not significantly related;LL is not significantly related to left and right ilium width ratio,coronal pelvic tilt angle,and lumbar cobb angle;left and right ilium width ratio is weakly correlated with coronal pelvic tilt angle,left and right ilium width ratio is related to lumbar spine The cobb angle is not significantly correlated;the coronal pelvic tilt angle is not significantly correlated with the lumbar spine Cobb angle.According to the correlation analysis between the changes in the values of the lumbar spine-pelvic parameters before and after treatment and the changes in the JOA score and the VAS score,it is concluded that the correlation between the changes before and after SS treatment and the PI is significant;the changes in the JOA score before and after treatment The correlation between the amount and the VAS score is significant.In addition,In addition,the Pearson correlation analysis results of other lumbar spine-pelvic parameters and JOA score,VAS score and other values before and after treatment are not correlated(P>0.05).Conclusion:(1)Compared with normal people,LDH patients with pelvic rotation have smaller parameters in PI,SS,LL.It is speculated that people with smaller PI,LL,and SS values are more likely to suffer from lumbar disc herniation.(2)In the research,the pelvic rotation state of LDH patients was mostly manifested in the coronal and sagittal planes,and the pelvic cross-sectional rotation was less.(3)Most of the LDH patients in the research developed lumbar scoliosis,but the occurrence of lumbar scoliosis was not significantly related to the rotation of the coronal,sagittal,and cross-sectional pelvis.(4)These two manipulations can improve the pain symptoms and daily activities of such patients with LDH.(5)These two manipulations can improve the parameters of LDH patients such as SS,PT,LL,left and right ilium width ratio,coronal pelvic inclination angle,and the corresponding lumbar pelvis of normal people The closeness of the parameters means that the sagittal curvature of the lumbar spine and the tilt and rotation of the pelvis in LDH patients are improved after treatment;the combination of the two methods has certain clinical significance for improving the biomechanical balance of the lumbar spine and pelvis.(6)Manipulations can improve the sagittal and coronal curvature of the lumbar spine,as well as the coronal,sagittal,and cross-sectional parameters of the pelvis,but the change in the curvature of the lumbar spine does not have a significant correlation with the change in the pelvic rotation state.