Spinal manipulation postepidural injection for lumbar and cervical radiculopathy: A retrospective case series
Spinal manipulation postepidural injection for lumbar and cervical radiculopathy: A retrospective case series
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DOI：
10.1016/j.jmpt.2004.06.003
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发表时间：
2004-09-01
影响因子：
1.3
通讯作者：
Dishman, JD
中科院分区：
文献类型：
--
作者：
Dougherty, P;Bajwa, S;Dishman, JD
目的：描述脊柱推拿硬膜外注射在非手术治疗颈椎和腰椎神经根病患者中的安全性和潜在治疗益处。方法：该研究设计是对在医院环境中接受脊柱推拿硬膜外注射的 20 名颈椎和 60 名腰椎神经根病患者的结果进行回顾性评价。患者接受荧光镜引导或计算机断层扫描 (CT) 引导的利多卡因和 Depo-Medrol 联合硬膜外注射。手法治疗包括立即硬膜外应用屈曲牵引动员，然后对受影响的脊柱区域进行高速、低幅度的脊柱操纵。结果标准根据经验定义为显着改善、暂时改善或无变化。所有患者的最短随访时间为 1 年。结果：没有出现与脊柱操作相关的并发症，而出现 3 例与硬膜外注射操作相关的并发症。在腰椎患者中，36.67% (n=22) 的患者出现显着改善，41.67% (n=25) 的患者出现暂时改善，21.67% (n=13) 的患者报告没有变化。颈椎硬膜外注射后接受脊柱推拿的患者中，50%（n=10）有显着改善，30%（n=6）经历暂时改善，而 20%（n=4）没有变化。 结论：这些数据表明，硬膜外注射后脊柱推拿是治疗脊髓源性神经根病患者的一种安全的非手术治疗方法。这也是首例在颈椎采用脊柱手法硬膜外注射的报道。
Objective: To describe the safety and potential therapeutic benefit of spinal manipulation postepidural injection in the nonsurgical treatment of patients with cervical and lumbar radiculopathy.Methods: The study design was a retrospective review of outcomes of 20 cervical and 60 lumbar radiculopathy patients who underwent spinal manipulation postepidural injection in a hospital setting. Patients received either fluoroscopically guided or computed tomography (CT)-guided epidural injection of a combination of lidocaine and Depo-Medrol. The manual therapy consisted of an immediate postepidural application of flexion distraction mobilization and then high-velocity, low-amplitude spinal manipulation to the affected spinal regions. Outcome criteria were empirically defined as significant improvement, temporary improvement, or no change. The minimum follow-up time for all patients was 1 year.Results: There were no complications associated with spinal manipulation, whereas 3 complications associated with the epidural injection procedure were noted. Of lumbar spine patients, 36.67% (n=22) noted significant improvement, 41.67% (n=25) experienced temporary improvement, and 21.67% (n=13) reported no change. Of the patients undergoing spinal manipulation after cervical epidural injection, 50%(n=10) noted significant improvement, 30% (n=6) experienced temporary improvement, whereas 20% (n=4) exhibited no change.Conclusions: These data suggest that spinal manipulation postepidural injection is a safe nonsurgical procedure to use in the treatment of the patient with radiculopathy of spinal origin. This is also the first report of the use of spinal manipulation postepidural injection in the cervical spine.