Treatment of cervical disc herniation by restoring internal-external spinal balance

FENG Wei; FENG Zihe; LIU Hongbo; AN Jianpeng; WANG Yarong

doi:10.3969/j.issn.2097-1753.2024.05.008

Abstract：Objective This study endeavors to undertake a comprehensive investigation into the clinical data of patients with cervical disc herniation who are receiving treatment informed by the principles of Feng's manipulation(FSM)therapy.Methods A retrospective cohort analysis was performed on 21 patients diagnosed with cervical disc herniation who underwent Feng's spinal manipulation(FSM)therapy at the Air Force Medical Center from December 2021 to December 2022,14 cases were radiculopathy type and 7 cases were myelopathy type.Outcome measures included clinical efficacy(VAS,NDI,and mJOA scores),body posture changes(assessed using deep learning-based human key point detection technology),joint capsule tenderness(evaluated using NRS and Wong-Baker scales),and radiographic parameters(C2-C7 Cobb angle,cervical centroid line angle,CCL,lumbar lordosis,LL,thoracic kyphosis,TK,Pavlov ratio,and sagittal index,SI).Results Compared with before treatment,both groups showed a decrease in VAS scores(P=0.001～0.017)and NDI scores(all P＜0.001)at discharge and long-term follow-up,and an increase in mJOA scores(P=0.001～0.005).The radiculopathy group demonstrated significant changes in shoulder balance angle pre-and post-treatment(F=8.589,P=0.001).Both groups exhibited a sharp reduction in NRS and W-B scores for joint capsule tenderness after treatment of distal vertebral displacement(t=13.015～39.782,all P≤0.001).The radiculopathy group showed increased Pavlov ratio and decreased SI after treatment(t=3.404,4.474,P=0.005,0.001).Conclusion Cervical disc herniation is attributable to a comprehensive internal-external spinal imbalance.Intervention utilizing Feng's Spinal Manipulation(FSM)therapy addresses the subluxation of single or multiple vertebrae,with the ultimate goal of reinstating spinal balance and achieving clinical cure.