中医正骨2026，Vol.38Issue(2)：14-22,9.
坐位腰椎旋扳手法操作中腰椎的骨性耦合运动特征研究
Study on the characteristics of bony coupled motion of lumbar spine during seated lumbar rotatory manipulation
摘要
Abstract
Objective:To analyze the characteristics of bony coupled motion of lumbar spine during seated lumbar rotatory manipula-tion.Methods:A 27-year-old healthy male volunteer was selected to undergo lumbar CT scans in the neutral position and at the endpoint of seated lumbar rotatory manipulation,respectively(taking the left-side manipulation as an example).A three-dimensional model of the entire lumbar bone structure was established based on CT scan data.The lateral bending angle,flexion-extension angle,and rotation angle of each lumbar segment relative to S,,and the rotation angle of the upper lumbar segment relative to the lower lumbar segment were measured,and the change values of each angle(the difference between the measured value at the manipulation endpoint and the measured value in the neu-tral position)were calculated.Results:①Measurement results of the position of each lumbar segment relative to S1.In the coronal plane,each lumbar segment showed mild right bending relative to S1 in the neutral position;at the manipulation endpoint,the lateral bending angle of each lumbar segment relative to S1 increased,showing a leftward shift.In the sagittal plane,lumbar segments shifted forward as a whole relative to S,in the neutral position,presenting a mild lordotic curve;at the manipulation endpoint,the lordotic flexion-extension angle of L,-L3 segments relative to S1 increased slightly,while L4 and L5 shifted backward.In the horizontal plane,each lumbar segment showed mild right rotation relative to S,in the neutral position;at the manipulation endpoint,the rotation angle of each lumbar segment relative to S,increased,all rotating to the left,but the rotation angle and the change value of the rotation angle gradually decreased from top to bottom.②Measurement results of the rotation angle of the upper lumbar segment relative to the lower segment.During the manipulation,the upper lumbar segment relative to the lower segment all rotated to the left.Relative to L5,the change values of the rotation angle of L,-L4 de-creased from top to bottom.When the reference point moved upward,except that the change value of the rotation angle of L3 relative to L4 was greater than that relative to L5,and the change value of the rotation angle of L,relative to L2 was greater than that relative to L3,the change values of the rotation angle of the upper segment relative to the lower segment also gradually decreased.Conclusion:During the seated lumbar rotatory manipulation,the upper lumbar spine(L1-L3)is the main area responding to the manipulation,with ipsilateral later-al bending coupling and lordosis coupling;the lower lumbar spine(L4,L5)mainly plays a role in maintaining stability,with ipsilateral lateral bending coupling and extension coupling;there is rotational coupling in the lumbar spine as a whole and between each lumbar segment.关键词
推拿,脊柱/腰椎/生物力学现象/限定因素分析Key words
manipulation,spinal/lumbar vertebrae/biomechanical phenomena/finite element analysis引用本文复制引用
高夕林,王明炜,谭军彦,黄朋涛,刘爱峰,王平,符碧峰..坐位腰椎旋扳手法操作中腰椎的骨性耦合运动特征研究[J].中医正骨,2026,38(2):14-22,9.基金项目
国家重点研发计划(2021YFC1712802) （2021YFC1712802）
国家中医药管理局中医药循证能力建设项目(2019XZZX-GK006) （2019XZZX-GK006）
天津中医药大学第一附属医院"拓新工程"基金科研课题(院ZZ2024010) （院ZZ2024010）
