Spinal manipulative-oriented therapy for lumbar disc herniation:quantitative X-ray analysis on the involved vertebral segment

Han Lei; Zhao Ping; Wang Fei; Wei Jie; Guo Wei

doi:10.3969/j.issn.2095-4344.2014.17.020

Abstract：BACKGROUND:Functional lumbar scoliosis is a major symptom of lumbar disc herniation. The reason for its occurrence was strongly associated with the disorder of biomechanics of affected segment structure besides nerve root stimulus. <br> OBJECTIVE:To analyze the mechanical impact of spinal manipulative therapy and other conservative treatment on functional scoliosis caused by lumbar disc herniation. <br> METHODS:A total of 56 cases of lumbar disc herniation with functional scoliosis were consecutively selected in the study. The samples were mainly treated by spinal manipulation and conventional conservative therapy. After one course of treatment, the rotation and tilting angle of the involved vertebrae were quantitatively analyzed by Logan Spine X-Ray Software System. Simultaneously, the alterations in scores of Japanese Orthopaedic Association and Visual Analogue Scale were recorded. <br> RESULTS AND CONCLUSION:The involved segment was proved abnormal y coupled with the mechanical tendency of spine list by Logan Spine X-ray analysis, i.e.,“uncompensated vertebrae”or“vertebral subluxation”. Moreover, there is a significant consistency with the troubled vertebra by palpation. After spinal manipulative therapy, the“uncompensated vertebrae”rotation reversed significantly and the segment was coupled normal y with the mechanical tendency of functional scoliosis of lumbar spine. It could be an evidence of a rebuilt of“compensated vertebral segment”. The entire lumbar spine list was also noticeably reduced. These changes were significantly associated with the changes of Japanese Orthopaedic Association score and Visual Analogue Scale score. Results suggested that compensatory rebalance of the involved vertebral segment is significantly associated with symptomatology improvement in the patients with lumbar disc herniation. These indicated that it is of great clinical significance of correcting“uncompensated vertebrae”or“vertebral subluxation”to recover compensatory spinal balance as principle of spinal manipulation.